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General NPI Number Information
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NPI Number | 1568682425
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Entity Type | Organization
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Legal Business Name | DR. LARRY WOMACK & ASSOCIATES, OPTOMETRISTS, P.C.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2518 HILLSBORO BLVD
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City | MANCHESTER
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State | TN
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Zip | 37355-6535
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Country | US
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Telephone | 931-723-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 203 S ARROWHEAD DR
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City | MC MINNVILLE
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State | TN
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Zip | 37110-2934
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. LARRY WOMACK
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Credential | O.D.
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Telephone | 931-474-5506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 2568
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License Number State | TN
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