Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FC0800X | Contact Lens |
NPI | 1619351954 |
---|---|
Provider Name | David Belshe |
First Address | Colorado Springs, CO 80909-1120 |
Second Address | Colorado Springs, CO 80909-1120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2015 |
Last Update Date | 16/07/2015 |