NPI 1770055352 · live from the CMS NPI Registry
Larry J Buchholz, OD
Optometrist in Cornelius, OR. National Provider Identifier 1770055352, active.
NPI record
| NPI | 1770055352 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 220 N Adair St, Cornelius, OR 97113 |
| Practice phone | 503-207-0630 |
| Mailing address | 1154 Ne Alexandria St, Hillsboro, OR 97124 |
| Enumerated | December 20, 2018 |
| Last updated | December 20, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 4410ATI (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.