Doctor Name: | MR. LARRY D. HAAS |
NPI Number: | 1700907136 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 1021S |
Business Practice Address: | 2286 E Main St Bexley, OH - 432092335 |
Business Phone Number: | 6142372200 |
Business Fax Number: | 6142372422 |
Mailing Address: | 2286 E Main St, BEXLEY |
State: | OH |
Postal Code: | 432092335 |
Phone Number: | 6142372200 |
Fax Number: | 6142372422 |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 01/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 1021S |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |