Organization
EASTLAKE VISION CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY R BLACK O.D. (PRESIDENT)
(303) 452-2020
Entity
Organization
Contact information
Practice address
12450 YORK ST, THORNTON, CO 80241-2741
(303) 452-2020
(303) 452-0934
Mailing address
12450 YORK ST, THORNTON, CO 80241-2741
(303) 452-2020
(303) 452-0934
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
830
CO
Other
Enumeration date
01/09/2008
Last updated
02/05/2008
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