Organization
OSGOOD EYECARE PROFESSIONALS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN LARSON OD (OWNER)
(320) 304-1027
Entity
Organization
Contact information
Practice address
4622 40TH AVE S, FARGO, ND 58104-4394
(701) 364-2909
(701) 364-9346
Mailing address
4622 40TH AVE S, FARGO, ND 58104-4394
(701) 364-2909
(701) 364-9346
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
685
ND
Other
Enumeration date
12/02/2011
Last updated
04/04/2012
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