Individual
LARRY RAY BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
101 MARKET PLACE BLVD, CARTERSVILLE, GA 30121-2236
(770) 386-9022
(770) 382-3188
Mailing address
101 MARKET PLACE BLVD, CARTERSVILLE, GA 30121-2236
(770) 386-9022
(770) 382-3188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1436
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00787355A
—
GA
Enumeration date
11/24/2005
Last updated
08/15/2011
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