Individual
KEITH JAMES BROOKS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6799 BISMARK RD, SUITE D, COLORADO SPRINGS, CO 80922-1189
(719) 574-2020
(719) 574-1391
Mailing address
6799 BISMARK RD, SUITE D, COLORADO SPRINGS, CO 80922-1189
(719) 574-2020
(719) 574-1391
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT1985
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
804889
GROUP IDENTIFIER
CO
Enumeration date
05/10/2006
Last updated
07/08/2007
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