Organization
SOUTHERN COLORADO EYE CARE ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL RAY COZZETTA O.D. (OPTOMETRIST/ OWNER)
(719) 542-3555
Entity
Organization
Contact information
Practice address
1620 FORTINO BLVD, PUEBLO, CO 81008-1856
(719) 542-3555
Mailing address
1620 FORTINO BLVD, PUEBLO, CO 81008-1856
(719) 542-3555
(719) 542-0776
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08013476
—
CO
01
—
1043277973
PROVIDER NPI
—
Enumeration date
03/17/2008
Last updated
03/11/2014
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