Individual
DR. STACY LYNNETTE RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
15530 E BRONCOS PKWY, SUITE 200, CENTENNIAL, CO 80112-7111
(303) 766-2020
(303) 680-8337
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
99183099
CO
152W00000X
Optometrist
Primary
OPT.0001830
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08183097
—
CO
Enumeration date
01/06/2007
Last updated
09/14/2021
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