Havrilla Vision Professional LLC

NPI #1043561863 in Longmont, Colorado

Provider Information

NPI Number: 1043561863
Entity Type: Organization
Organization Name: Havrilla Vision Professional LLC
Primary Specialty: Optometrist
Enumeration Date: Sep 20, 2012
Last Updated: Sep 20, 2012

Practice Location

Address: 551 S HOVER ST
City: Longmont
State: Colorado
ZIP Code: 80501-7920
Phone: (970) 629-1325

Authorized Official

Name: JENNIFER HAVRILLA, O.D.
Title: OWNER
Phone: (970) 629-1325

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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