Organization
APPLING EYE CLINIC,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY E FORTH OD (DOCTOR)
(912) 367-7754
Entity
Organization
Contact information
Practice address
77 N MAIN ST, BAXLEY, GA 31513-0567
(912) 367-7754
(912) 367-0775
Mailing address
PO BOX 70, BAXLEY, GA 31515-0070
(912) 367-7754
(912) 367-0775
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT000842
GA
Other
Enumeration date
02/22/2006
Last updated
03/13/2008
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