Organization
4D OPTOMETRY, LLC
Active
Other names
4D Vision Gym
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUANITA D COLLIER MS, OD (OPTOMETRIST)
(860) 632-8243
Entity
Organization
Contact information
Practice address
181 SHUNPIKE RD, CROMWELL, CT 06416-1143
(860) 632-8423
Mailing address
181 SHUNPIKE RD, CROMWELL, CT 06416-1143
(860) 632-8423
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
2779
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11999461
CAQH
—
Enumeration date
06/17/2013
Last updated
06/17/2013
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