Organization
LARRY L. MINIX DBA THE OPTICAL SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY L. MINIX OPTICIAN HIS (OWNER)
(270) 926-4933
Entity
Organization
Contact information
Practice address
1115 TAMARACK RD, SUITE 100, OWENSBORO, KY 42301-6984
(270) 926-4933
(270) 688-0627
Mailing address
1115 TAMARACK RD, SUITE 100, OWENSBORO, KY 42301-6984
(270) 926-4933
(270) 688-0627
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
237700000X
Hearing Instrument Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52800315
—
KY
05
—
52903945
—
KY
Enumeration date
10/02/2006
Last updated
09/16/2009
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