| Organization Name: | LARRY D TERRY A PROFESSIONAL CORPORATION |
| NPI Number: | 1811217383 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LARRY DEAN TERRY (OWNER) |
| Mailing Address: | 34 S Main St Brigham City |
| State: | UT US |
| Postal Code: | 843022527 |
| Phone Number: | 4357232485 |
| Fax Number: | 4357235840 |
| NPI Enumeration Date: | 06/08/2010 |
| NPI Last Update Date: | 11/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | 1125909934 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |