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Contact Information

CCC OPTICAL PC
480 WOLVERINE DR
SUITE 5
BAYFIELD, CO81122-9653
 Phone: 970-884-6188
 Fax: 970-884-2869
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for CCC OPTICAL PC · (Female)

NPI # 1184612616
Status Active
Credentials
Entity Individual
Enumeration date 10/10/2005
Last updated 01/05/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • CO License # 1409
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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