Individual
DR. LARRY L FORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2080 N MAIN ST, LONGMONT, CO 80501-1916
(303) 651-2020
Mailing address
2080 N MAIN ST, LONGMONT, CO 80501-1916
(303) 651-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
850
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08008500
—
CO
Enumeration date
08/29/2006
Last updated
05/23/2012
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