Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 3001 | CO |
NPI | 1003257213 |
---|---|
Provider Name | Joseph P Austin |
First Address | Lakewood, CO 80401-3247 |
Second Address | Colorado Springs, CO 80920-3187 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2013 |
Last Update Date | 08/10/2014 |