Organization
PINE CREEK VISION CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY JOHNSTON (OWNER/ DOCTOR)
(719) 594-2020
Entity
Organization
Contact information
Practice address
9475-A BRIAR VILLAGE PT, SUITE 200, COLORADO SPRINGS, CO 80920-7902
(719) 594-2020
(719) 694-8562
Mailing address
9475-A BRIAR VILLAGE PT, SUITE 200, COLORADO SPRINGS, CO 80920-7902
(719) 594-2020
(719) 694-8562
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1380
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DU0051
RAILROAD MEDICARE PTAN
CO
Enumeration date
12/08/2011
Last updated
07/13/2026
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