person
Larry Tate, LDO
Optician in Corbin, Kentucky
NPI 1336559186

Larry Tate is a Optician based in Corbin, KY and is specialized in Optician. Larry Tate practices in Corbin, KY and has the professional credentials of LDO. The NPI Number for Larry Tate is 1336559186 and holds a License No. 0567 (Kentucky).

The current practice location address for Larry Tate is 107 Kentucky Street, Corbin, KY and can be reached out via phone at 606-528-2833 and via fax at 606-528-2862.

Location: 107 Kentucky Street, Corbin, KY, 40702-0420
person
Provider Profile Details
NPI Number
1336559186
Provider Name
Larry Tate
Credential
LDO
Provider Entity Type
Individual
Gender
Male
Address
107 Kentucky Street, Corbin, KY, 40702-0420
Phone Number
606-528-2833
Fax Number
606-528-2862
Provider Enumeration Date
05/02/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
52905676 05 KY
institution
Provider Business Practice Location Address Details
Address
107 Kentucky Street
City
State
Zip
40701
Phone Number
606-528-2833
Fax Number
606-528-2862
person
Provider Business Mailing Address Details
Address
107 Kentucky Street
City
State
Zip
40701
Phone Number
606-528-2833
Fax Number
606-528-2862
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
0567 (Kentucky)
Definition
Definition to come...
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