Provider Demographics
NPI:1538894316
Name:GOETTEMOELLER, LAUREN (OD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GOETTEMOELLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 DECATUR ST APT 315
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4320
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:303-424-8291
Practice Address - Street 1:7913 ALLISON WAY STE 102
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-4450
Practice Address - Country:US
Practice Address - Phone:303-424-5282
Practice Address - Fax:303-424-8291
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003782152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist