| Organization Name: | ALPINE OPTICAL OF WESTERN COLORADO LLC |
| NPI Number: | 1003990532 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH L LINENBERGER (MEMBER/OPTICIAN) |
| Mailing Address: | 1800 E Pavilion Pl Suite A Montrose |
| State: | CO US |
| Postal Code: | 814015337 |
| Phone Number: | 9702491186 |
| Fax Number: | 9702491677 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 03/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |