Organization
UNDERWOOD OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT D UNDERWOOD OD (OPTOMETRIST)
(970) 565-7195
Entity
Organization
Contact information
Practice address
22 S BEECH ST, CORTEZ, CO 81321-3744
(970) 565-7195
(970) 565-7171
Mailing address
PO BOX 959, CORTEZ, CO 81321-0959
(970) 565-7195
(970) 565-7171
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1245
CO
332H00000X
Eyewear Supplier
Primary
1245
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08124596
—
CO
01
—
3444
BCBS
CO
Enumeration date
06/13/2007
Last updated
11/03/2011
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