Forrest, Larry L

Forrest, Larry L is an individual health care provider with primary practice located at 2080 N Main St , Longmont CO 80501-1916. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Forrest, Larry L can be contacted via phone (303) 651-2020.

Contact Information

Primary practice address
2080 N Main St Longmont CO 80501-1916
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 850 Colorado

Profile Details

NPI number 1386752343
LBN Legal business name Forrest, Larry L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated May 23rd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386752343 NPPES
Colorado MEDICAID 08008500

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