Organization
LARRY J LATOUR OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY J LATOUR OD PA (OPTOMETRIST PRESIDENT)
(386) 462-7772
Entity
Organization
Contact information
Practice address
15551 NW 441 UNIT 110, ALACHUA, FL 32616
(386) 462-7772
(386) 462-1122
Mailing address
PO BOX 2170, ALACHUA, FL 32616
(386) 462-7772
(386) 462-1122
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC0001543
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078166500
—
FL
Enumeration date
08/08/2006
Last updated
10/22/2012
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