Earl J Primo Ms Od LLC
Optometrist in Covington, LA. Organization (NPI-2).
NPI number1558502971
StatusActive
Last updated in NPPESMar 11, 2019
Details
- NPI
- 1558502971
- Entity type
- Organization (NPI-2)
- Legal business name
- Earl J Primo Ms Od LLC
- Organization subpart
- No
- Enumeration date
- Mar 14, 2009
- Last updated
- Mar 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 1332-466T | LA | Yes |
Practice location
880 N Highway 190Covington, LA 70433-5147
Phone 985-867-8708 · Fax 985-867-8711
Mailing address
205 Stonewood DrCovington, LA 70433-5819
Phone 504-606-1701 · Fax 985-871-9953
Authorized official
Earl J Primo
Owner
9858678708
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