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General NPI Number Information
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NPI Number | 1558508952
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Entity Type | Organization
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Legal Business Name | DR. PHILIP LARRABEE AND ASSOCIATES OPTOMETRISTS, LLC
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 12200 CHATTANOOGA PLZ
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-4865
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Country | US
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Telephone | 804-744-7327
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Fax | 804-744-7328
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Provider Business Mailing Address
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Address Line | 4617 LEONARD PKWY
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City | RICHMOND
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State | VA
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Zip | 23226
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Country | US
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Telephone | 804-359-1035
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Fax | 804-359-1035
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Authorized Official
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Title or Position | OPTOMETRIST/PRESIDENT
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Name | DR. PHILIP LARRABEE
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Credential | O.D.
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Telephone | 757-880-3320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0618000324
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000324
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License Number State | VA
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