Individual
DONAT JUTRAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LO
Contact information
Practice address
927 FARMINGTON AVE, BRISTOL, CT 06010-3927
(860) 589-6475
Mailing address
927 FARMINGTON AVE, BRISTOL, CT 06010-3927
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
688
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871690131
—
CT
Enumeration date
06/16/2015
Last updated
06/16/2015
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