Individual
TARA K KEESEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4344 WOODLANDS BLVD STE 100, CASTLE ROCK, CO 80104-2801
(303) 688-3636
(303) 688-1036
Mailing address
4344 WOODLANDS BLVD STE 100, CASTLE ROCK, CO 80104-2801
(303) 688-3636
(303) 688-1036
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
02188
IA
152W00000X
Optometrist
046009288
IL
152W00000X
Optometrist
Primary
OPT.0004011
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0225540
—
IA
01
—
23999
BCBS
IA
Enumeration date
07/09/2006
Last updated
10/03/2024
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