Individual
AARON LARRY MOTACEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1300 GATEWAY DR S, FARGO, ND 58103-3509
(701) 235-0280
Mailing address
4906 28TH AVE S APT 404, FARGO, ND 58104-9020
(701) 320-2738
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
773
ND
Other
Enumeration date
05/23/2020
Last updated
05/23/2020
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