Individual
DR. GARRETT MOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
658 GENOA WAY STE B, CASTLE ROCK, CO 80109-3891
(303) 337-2020
(303) 337-2053
Mailing address
3241 S MICHIGAN AVE, ICO BOX 94, CHICAGO, IL 60616-4201
(701) 720-0009
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.0003156
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467957746
—
CO
Enumeration date
06/02/2015
Last updated
03/04/2019
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