Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2759 | CO |
NPI | 1003141045 |
---|---|
Provider Name | Dr. Lauren Elizabeth Kimmel |
First Address | Denver, CO 80210-4042 |
Second Address | Denver, CO 80210-4042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2009 |
Last Update Date | 08/10/2009 |