| NPI | 1215376967 |
|---|---|
| Doing Business As | 4D VISION GYM |
| Entity Type | Organization |
| Authorized Contact | JUANITA D COLLIER O PT Ometrist 860-632-8243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist Vision Therapy (Licence: CT 2779) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2013-06-17 |