Individual
ETHAN BRILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3745 DACORO LN STE 100, CASTLE ROCK, CO 80109-2500
(720) 375-5625
Mailing address
3745 DACORO LN STE 100, CASTLE ROCK, CO 80109-2500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3320
CO
Other
Enumeration date
07/14/2017
Last updated
08/31/2024
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