Organization
THORNTON YOUTH VISION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER LOGAN (BUSINESS MANAGER)
(719) 200-5623
Entity
Organization
Contact information
Practice address
9674 WASHINGTON ST UNIT 104, THORNTON, CO 80229-2160
(303) 450-0184
Mailing address
1400 GROVE ST, DENVER, CO 80204-2229
(719) 200-5623
(719) 960-2654
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000168991
—
CO
Enumeration date
11/07/2018
Last updated
06/24/2020
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