Individual
MRS. LARISSA MARIE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CERTIFIED OPTICIAN
Contact information
Practice address
3565 DEL AMO BLVD, TORRANCE, CA 90503-1637
(310) 214-0811
(310) 793-4658
Mailing address
PO BOX 6900, TORRANCE, CA 90504-0100
(310) 214-0811
(310) 793-4658
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
173420
CA
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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