Individual
MR. LARRY CHARLES WENTWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23 VASSALBORO RD, SOUTH CHINA, ME 04358-5203
(120) 748-5616
Mailing address
23 VASSALBORO RD, SOUTH CHINA, ME 04358-5203
(120) 748-5616
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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