Moen, Garrett
Moen, Garrett is an sole proprietor health care provider with primary practice located at 658 Genoa Way Ste B , Castle Rock CO 80109-3891. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moen, Garrett can be contacted via phone (303) 337-2020.Contact Information
Primary practice address
658 Genoa Way Ste B
Castle Rock CO 80109-3891
Phone: (303) 337-2020
Fax: (303) 337-2053
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT.0003156 | Colorado |
Profile Details
| NPI number | 1629458930 |
|---|---|
| LBN Legal business name | Moen, Garrett |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 2nd, 2015 |
| Last updated | Mar 4th, 2019 - about 6 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 | 1629458930 | NPPES |
| Colorado | MEDICAID | 1467957746 |
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