Organization
LACY MOSER BOGGS, OD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LACY BOGGS (OWNER)
(317) 385-1230
Entity
Organization
Contact information
Practice address
112 W WASHINGTON ST, SUITE 101, LEBANON, IN 46052-2590
(317) 385-1230
Mailing address
112 W WASHINGTON ST, SUITE 101, LEBANON, IN 46052-2590
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003549
IN
Other
Enumeration date
08/20/2010
Last updated
09/28/2010
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