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General NPI Number Information
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NPI Number | 1043313661
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Entity Type | Organization
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Legal Business Name | LANDRETH & ASSOCIATES INC
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 311 1ST STREET
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City | REFORM
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State | AL
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Zip | 35481
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Country | US
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Telephone | 205-375-8200
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Fax | 205-375-8234
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Provider Business Mailing Address
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Address Line | PO BOX 59 311 1ST STREET
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City | REFORM
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State | AL
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Zip | 35481-0059
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Country | US
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Telephone | 205-375-8200
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Fax | 205-375-8234
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEVEN RODNEY LANDRETH
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Credential | OD
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Telephone | 205-375-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S914TA467
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License Number State | AL
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