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Individual

DR. LARRY A KOVAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2705 N LEBANON ST STE 230, LEBANON, IN 46052-8627
(765) 482-2066
(765) 482-4847
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002079
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201164040
IN
Enumeration date
07/20/2006
Last updated
12/13/2021
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