Lervick, Dale G

Lervick, Dale G is an sole proprietor health care provider with primary practice located at 7586 W Jewell Ave Suite 104, Lakewood CO 80232-6890. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lervick, Dale G can be contacted via phone (303) 233-7575.

Contact Information

Primary practice address
7586 W Jewell Ave Suite 104 Lakewood CO 80232-6890
Fax: (303) 233-4740
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 777 Colorado

Profile Details

NPI number 1326047077
LBN Legal business name Lervick, Dale G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2005
Last updated Apr 25th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326047077 NPPES
Colorado MEDICAID 08007775
Colorado Other 32959

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