Individual
LANCE ABERNATHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
8351T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0618002159
VIRGINIA STATE LICENSE
VA
Enumeration date
07/02/2012
Last updated
05/04/2017
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