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DR. PAUL WILLIAM HEERSINK O.D.
>> Optometrist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1750367231
Individual Registrant:DR. PAUL WILLIAM HEERSINK O.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
101 CHICO CT SUITE B MONTE VISTA, CO 81144-1067 US
Tel: 719-852-3412 Fax: 719-852-3345
Tel: 719-852-3412 Fax: 719-852-3345
Contact information for business:
101 CHICO CT SUITE B MONTE VISTA, CO 81144-1067 US
Tel: 719-852-3412 Fax: 719-852-3345
Tel: 719-852-3412 Fax: 719-852-3345
Registration Information:
NPI: 1750367231
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 152W00000X | Eye and Vision Services Providers Optometrist | CO | 990 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 08009904 | CO | 05 |
