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DR. PAUL WILLIAM HEERSINK O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1750367231

Individual Registrant:
DR. PAUL WILLIAM HEERSINK O.D.
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

Contact information for business:
101 CHICO CT SUITE B MONTE VISTA, CO 81144-1067 US
Tel: 719-852-3412  Fax: 719-852-3345

Registration Information:
NPI: 1750367231
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
CO990

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
08009904CO05




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