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Individual

LARRY L WASHBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
505 N FRANKLIN AVE, STE B, COLBY, KS 67701-2356
(785) 462-3348
(785) 462-3599
Mailing address
PO BOX 747, 505 N FRANKLIN AVE, COLBY, KS 67701-0747
(785) 462-3348
(785) 462-3599

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1111-3
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100090170A
KS
Enumeration date
09/28/2007
Last updated
11/04/2008
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