Individual
DR. TYLER W PERSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4803 WARD RD, WHEAT RIDGE, CO 80033-1902
(303) 338-4545
Mailing address
4803 WARD RD, WHEAT RIDGE, CO 80033-1902
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0002978
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01073311
—
CO
01
—
025966
KAISER COMMERCIAL NUMBER
CO
Enumeration date
06/06/2013
Last updated
02/20/2015
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