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Individual

LARRY CLAY COTTEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OPTICIAN

Contact information

Practice address
6306 LAKE WORTH BLVD, SUITE A, LAKE WORTH, TX 76135-3608
(817) 626-9533
Mailing address
6306 LAKE WORTH BLVD, SUITE A, LAKE WORTH, TEXAS 76135
(817) 626-9533

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
090096
TX

Other

Enumeration date
02/07/2010
Last updated
02/07/2010
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