Individual
SCOTT KENNETH THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4804 CHAMBERS RD, DENVER, CO 80239-5152
(303) 576-6655
Mailing address
4804 CHAMBERS RD, DENVER, CO 80239-5152
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618003264
VA
152W00000X
Optometrist
Primary
3691
CO
Other
Enumeration date
03/30/2023
Last updated
07/12/2024
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