Larry L Waggoner DOCTOR OF OPTOMETRY

NPI 1710065727 - Optometrist - 152W00000X

NPI Details
NPI 1710065727
Gender Male
Enumeration Date 11/01/2006
Last Updated 08/23/2010
Entity Type Individual
Active Over 10 years ago
Practice Location
12134 MT MESA RD
LAKE ISABELLA CA, 93240, US
Phone (760) 379-3602
Fax (760) 379-2232
Business Location
12134 MT MESA RD
LAKE ISABELLA CA, 93240, US
Phone (760) 379-3602
Fax (760) 379-2232
Toxanomy
Taxonomy Code 152W00000X
License State California
License Number 6133T
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According to our database, Mr. Larry L Waggoner DOCTOR OF OPTOMETRY NPI is 1710065727, taxonomy code is 152W00000X and license number is 6133T, license state is located at California. Larry L Waggoner DOCTOR OF OPTOMETRY physically located at 12134 Mt Mesa Rd, Lake Isabella CA, 93240. NPI Number Larry L Waggoner DOCTOR OF OPTOMETRY has the Individual type.

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1710065727 NPI number is provided on an as is basis without warranty of any kind. 1710065727 is maintained by the National Plan & Provider Enumeration System. The contents of Larry L Waggoner DOCTOR OF OPTOMETRY are for informational purposes only.