Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OP2560 | CO |
NPI | 1013094689 |
---|---|
Provider Name | Kent Ramsey Godfrey |
First Address | Greenwood Village, CO 80111-1352 |
Second Address | Greenwood Village, CO 80111-1352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 21/05/2009 |