# LARRY L. MINIX DBA THE OPTICAL SHOPPE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598858300
- **Authorized official:** MR. LARRY L. MINIX OPTICIAN HIS (OWNER)
- **Authorized official phone:** (270) 926-4933

## Contact information

- **Practice address:** 1115 TAMARACK RD, SUITE 100, OWENSBORO, KY 42301-6984
- **Practice address phone:** (270) 926-4933
- **Practice address fax:** (270) 688-0627
- **Mailing address:** 1115 TAMARACK RD, SUITE 100, OWENSBORO, KY 42301-6984
- **Mailing address phone:** (270) 926-4933
- **Mailing address fax:** (270) 688-0627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | — | NULL | Yes |
| 156FX1800X | Optician | — | — | Yes |
| 237700000X | Hearing Instrument Specialist | — | NULL | — |
| 237700000X | Hearing Instrument Specialist | — | — | — |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 09/16/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 52800315 | — | KY |
| 05 | — | 52903945 | — | KY |