Larry Lee Nicholson II O.D.

NPI 1053313338 - Optometrist - 152W00000X

NPI Details
NPI 1053313338
Gender Male
Enumeration Date 06/01/2005
Last Updated 07/16/2015
Entity Type Individual
Active Over 11 years ago
Practice Location
19870 MAIN E ST
HUNTINGDON TN, 38344-3927, US
Phone (731) 986-4400
Fax (731) 986-7981
Business Location
19870 MAIN E ST
HUNTINGDON TN, 38344-3927, US
Phone (731) 986-4400
Fax (731) 986-7981
Toxanomy
Taxonomy Code 152W00000X
License State Tennessee
License Number ODT2544
Remove 1053313338 NPI Number
 

According to our database, Dr. Larry Lee Nicholson II O.D. NPI is 1053313338, taxonomy code is 152W00000X and license number is ODT2544, license state is located at Tennessee. Larry Lee Nicholson II O.D. physically located at 19870 Main E St, Huntingdon TN, 38344-3927. NPI Number Larry Lee Nicholson II O.D. has the Individual type.

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1053313338 NPI number is provided on an as is basis without warranty of any kind. 1053313338 is maintained by the National Plan & Provider Enumeration System. The contents of Larry Lee Nicholson II O.D. are for informational purposes only.