Individual
JUSTIN RICHARD GLISKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
530 21ST STREET, VERO BEACH, FL 32960
(772) 562-2020
(772) 562-5874
Mailing address
530 21ST STREET, VERO BEACH, FL 32960
(772) 562-2020
(772) 562-5874
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002663
CT
152W00000X
Optometrist
Primary
3799
FL
152W00000X
Optometrist
TUV006880
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620846100
—
FL
Enumeration date
09/07/2006
Last updated
07/08/2007
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