Larry-W-Bloomingburg-Od

NPI #1952571895 in Henderson, Tennessee

Provider Information

NPI Number
1952571895
Entity Type
Organization
Organization Name
Larry-W-Bloomingburg-Od
Primary Specialty
Eyewear Supplier
Enumeration Date
Mar 6, 2008
Last Updated
Mar 6, 2008

Practice Location

Address
138 S WASHINGTON AVE
ZIP Code
38340-2323
Phone
(731) 989-3511

Authorized Official

Name
DR. LARRY W BLLOMINGBURG, O.D.
Title
OWNER
Phone
(731) 989-3511

Specialties & Taxonomy Codes

Specialty
Eyewear Supplier

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