Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2750 | CO |
NPI | 1003141011 |
---|---|
Provider Name | Dr. Valencia Z Lo |
First Address | Denver, CO 80212-7338 |
Second Address | Denver, CO 80212-7338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2009 |
Last Update Date | 30/09/2015 |