Organization
LOVELAND VISION PROF CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL EDWARD KODITEK (OWNER)
(970) 663-3937
Entity
Organization
Contact information
Practice address
1325 DENVER AVE, LOVELAND, CO 80537-5120
(970) 663-3937
(970) 669-7518
Mailing address
1325 DENVER AVE, LOVELAND, CO 80537-5120
(970) 663-3937
(970) 669-7518
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2850
CO
Other
Enumeration date
12/27/2011
Last updated
05/31/2012
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