Organization
EARL J PRIMO MS OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARL J PRIMO O.D. (OWNER)
(985) 867-8708
Entity
Organization
Contact information
Practice address
880 N HIGHWAY 190, COVINGTON, LA 70433-5147
(985) 867-8708
(985) 867-8711
Mailing address
205 STONEWOOD DR, COVINGTON, LA 70433-5819
(504) 606-1701
(985) 871-9953
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1332-466T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1153796
—
LA
Enumeration date
03/14/2009
Last updated
03/11/2019
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