Individual
JULIA MARIE COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2947 RODEO PARK DR E, SANTA FE, NM 87505-6303
(505) 983-6613
(505) 213-0103
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 828-4923
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
14408
CA
152W00000X
Optometrist
Primary
683
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609130988
NPI
NM
Enumeration date
07/01/2012
Last updated
09/27/2016
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