Individual
SHELLEY CLARK RACHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
6800 N 79TH ST STE 101, NIWOT, CO 80503-8978
(303) 652-0505
Mailing address
196 MAXWELL CIR, ERIE, CO 80516-8409
(630) 532-4998
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
0003731
CO
Other
Enumeration date
06/24/2020
Last updated
10/03/2023
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