Individual
MARIA LAVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4804 CHAMBERS RD, DENVER, CO 80239-5152
(303) 576-6655
Mailing address
285 WOLF DEN RD, ROYSTON, GA 30662-8230
(706) 436-9479
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.000331
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/28/2017
Last updated
07/21/2022
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