Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 1464 | CO |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 1464 | CO |
N | 152WP0200X | Pediatric Optomitrist | 1464 | CO |
N | 152WV0400X | Optomitrist - Vision Therapist | 1464 | CO |
NPI | 1154474187 |
---|---|
Provider Name | Dr. Kevin C. Pollard |
First Address | Denver, CO 80204-1024 |
Second Address | Denver, CO 80204-1024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2007 |
Last Update Date | 06/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T83821 | (02) | CO |