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Individual

DR. LARRY DON PECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
716 AVENUE G, FORT MADISON, IA 52627-2927
(319) 372-2321
(319) 372-2850
Mailing address
716 AVENUE G, FORT MADISON, IA 52627-2927
(319) 372-2321
(319) 372-2850

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1719
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2900894
IA
Enumeration date
09/13/2005
Last updated
07/21/2022
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