Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT0003076 | CO |
NPI | 1003223611 |
---|---|
Provider Name | Amy Elsila |
First Address | Greenwood Village, CO 80111-2528 |
Second Address | Greenwood Village, CO 80111-2528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2014 |
Last Update Date | 24/05/2016 |