Organization
FRONT RANGE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE S JOHNSON M.C. (OWNER)
(303) 772-3818
Entity
Organization
Contact information
Practice address
1319 VIVIAN ST, LONGMONT, CO 80501
(303) 772-3818
Mailing address
1319 VIVIAN ST, LONGMONT, CO 80501-3216
(303) 772-3818
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
07-69569-0000
CO
Other
Enumeration date
12/29/2006
Last updated
01/22/2009
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