Organization
CORTEZ VISION PC
Active
Other names
Cortez Vision Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRYCE TANNER (OWNER)
(970) 565-2020
Entity
Organization
Contact information
Practice address
2423 E MAIN ST STE 4, CORTEZ, CO 81321-4269
(970) 565-2020
(970) 565-3632
Mailing address
PO BOX 820, CORTEZ, CO 81321-0820
(970) 565-2020
(970) 565-3632
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2046
CO
152W00000X
Optometrist
2803
CO
152W00000X
Optometrist
904
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06979238
—
CO
Enumeration date
12/18/2006
Last updated
03/14/2024
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