Provider Demographics
NPI:1962896373
Name:DR. HEATHER SANNER INC
Entity type:Organization
Organization Name:DR. HEATHER SANNER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SANNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:719-510-7219
Mailing Address - Street 1:353 N ACADEMY BLVD
Mailing Address - Street 2:INSIDE EYEGLASS WORLD
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-6605
Mailing Address - Country:US
Mailing Address - Phone:719-574-3300
Mailing Address - Fax:719-574-3322
Practice Address - Street 1:353 N ACADEMY BLVD
Practice Address - Street 2:INSIDE EYEGLASS WORLD
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-6605
Practice Address - Country:US
Practice Address - Phone:719-574-3300
Practice Address - Fax:719-574-3322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2546152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty