Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | CH-0005899 | FL |
NPI | 1609098680 |
---|---|
Provider Name | Dr. Gary L Farr |
First Address | Clearwater, FL 33755-4009 |
Second Address | Clearwater, FL 33755-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 08/07/2007 |