Organization
LARRY D TERRY A PROFESSIONAL CORPORATION
Active
Other names
Box Elder Family Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY DEAN TERRY O.D. (OWNER)
(435) 723-2485
Entity
Organization
Contact information
Practice address
34 S MAIN ST, BRIGHAM CITY, UT 84302-2527
(435) 723-2485
(435) 723-5840
Mailing address
34 S MAIN ST, BRIGHAM CITY, UT 84302-2527
(435) 723-2485
(435) 723-5840
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
1125909934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528920068006
—
UT
Enumeration date
06/08/2010
Last updated
10/02/2019
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