Larry E Forth O D P C

NPI #1306966791 in Fitzgerald, Georgia

Provider Information

NPI Number: 1306966791
Entity Type: Organization
Organization Name: Larry E Forth O D P C
Primary Specialty: Optometrist
Enumeration Date: Mar 30, 2007
Last Updated: Oct 20, 2008

Practice Location

Address: 708 S GRANT ST
Address 2: SUITE #18
City: Fitzgerald
State: Georgia
ZIP Code: 31750
Phone: (229) 423-5556

Authorized Official

Name: DR. LARRY E FORTH
Title: OPTOMETRIST
Phone: (229) 423-5556

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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