Organization
MOUNTAIN VALLEY EYE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON TIBBITTS OD (OWNER/OPTOMETRIST)
(719) 948-7941
Entity
Organization
Contact information
Practice address
2509 MAIN ST, ALAMOSA, CO 81101-2239
(719) 589-0825
Mailing address
2509 MAIN ST, ALAMOSA, CO 81101-2239
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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