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JOSHUA PAUL HEERSINK OD
>> Optometrist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1538646468
Individual Registrant: JOSHUA PAUL HEERSINK OD
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
101 CHICO CT UNIT B MONTE VISTA, CO 81144-1068 US
Tel: 719-852-3412 Fax: --
Tel: 719-852-3412 Fax: --
Contact information for business:
101 CHICO CT UNIT B MONTE VISTA, CO 81144-1068 US
Tel: 719-852-3412 Fax: --
Tel: 719-852-3412 Fax: --
Registration Information:
NPI: 1538646468
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 152W00000X | Eye and Vision Services Providers Optometrist | CO | 0003400 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
