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Individual

LARRY COOPER KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3520 OAKDALE RD. STE. B, MODESTO, CA 95357-0714
(209) 847-7775
(209) 847-7728
Mailing address
3520 OAKDALE RD STE. B, MODESTO, CA 95357
(209) 847-7775
(209) 847-7728

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA3557
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HA0035570
CA
01
HA3557
LICENCE #
CA
Enumeration date
02/14/2007
Last updated
08/04/2011
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