| NPI | 1871769950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRANCE EDWIN LARSON Owner/Optometrist 916-983-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 6725T) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |