Organization
ABBA DRY EYE & ALLERGY CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY WINTER (PROVIDER COORDINATOR)
(719) 424-4497
Entity
Organization
Contact information
Practice address
4465 NORTHPARK DR STE 206, COLORADO SPRINGS, CO 80907-4238
(719) 424-4496
(719) 301-1518
Mailing address
1130 LAKE PLAZA DR STE 145, COLORADO SPRINGS, CO 80906-3595
(719) 630-8200
(719) 630-8201
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1000
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CO
Enumeration date
08/24/2017
Last updated
08/24/2017
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