Individual
DR. JUSTIN DANIEL DEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1200 S HOVER ST, LONGMONT, CO 80501-7902
(303) 845-4215
(303) 682-8181
Mailing address
1200 S HOVER ST, LONGMONT, CO 80501-7902
(303) 845-4215
(303) 682-8181
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2875
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54686270
—
CO
Enumeration date
09/06/2011
Last updated
09/27/2016
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