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
Phone: (303) 233-7575
Fax: (303) 233-4740
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1326047077 | NPPES |
Colorado | MEDICAID | 08007775 | |
Colorado | Other | 32959 |
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