Brent W Fidler

NPI #1083888721 in Estes Park, Colorado

Provider Information

NPI Number: 1083888721
Entity Type: Organization
Organization Name: Brent W Fidler
Subpart: Yes (part of a larger organization)
Parent Organization: BRENT W FIDLER
Primary Specialty: Optometrist
Enumeration Date: Apr 14, 2008
Last Updated: Jun 25, 2008

Practice Location

Address: 455 E WONDER VIEW AVE
Address 2: STE. B1
City: Estes Park
State: Colorado
ZIP Code: 80517-9647
Phone: (970) 577-1027

Authorized Official

Name: DR. BRENT W FIDLER, O.D.
Title: OPTOMETRIST
Phone: (970) 577-1027

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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