Individual
DR. LARRY ROBERT KINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1800 E PAVILION PL UNIT B, MONTROSE, CO 81401-5499
(197) 024-9121
(970) 249-3057
Mailing address
1800 E PAVILION PL UNIT B, MONTROSE, CO 81401-5499
19702491210
(970) 249-3057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1477
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80152201
—
CO
Enumeration date
01/05/2006
Last updated
09/28/2017
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