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Individual

ERIC NOEL LARSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
7324 W CHEYENNE AVE, SUITE 1, LAS VEGAS, NV 89129-7427
(702) 259-3937
(702) 645-6402
Mailing address
7324 W CHEYENNE AVE, SUITE 1, LAS VEGAS, NV 89129-7427
(702) 259-3937
(702) 645-6402

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
880426207
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05101
MES
NV
05
2502015
NV
01
5840350
AETNA
NV
01
NV0223
NV LICENSE
NV
Enumeration date
11/02/2006
Last updated
12/23/2008
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