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Mr. Larry Charles Wentworth
Optician in South China, Maine
NPI 1972227015

Larry Charles Wentworth is a Optician based in South China, ME and is specialized in Optician. Larry Charles Wentworth practices in South China, ME. The NPI Number for Larry Charles Wentworth is 1972227015 and holds a License No. (Maine).

The current practice location address for Larry Charles Wentworth is 23 Vassalboro Rd, South China, ME and can be reached out via phone at 120-748-5616.

Location: 23 Vassalboro Rd, South China, ME, 04358-5203
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972227015
Provider Name
Larry Charles Wentworth
Credential
Provider Entity Type
Individual
Gender
Male
Address
23 Vassalboro Rd, South China, ME, 04358-5203
Phone Number
120-748-5616
Fax Number
Provider Enumeration Date
10/03/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
23 Vassalboro Rd
City
South China
State
Maine
Zip
04358-5203
Phone Number
120-748-5616
Fax Number
person
Provider Business Mailing Address Details
Address
23 Vassalboro Rd
City
South China
State
Maine
Zip
04358-5203
Phone Number
120-748-5616
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
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Definition
Definition to come...
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