Individual
JEREMIAH BLAINE LANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 VIRGINIA ST E STE 400, CHARLESTON, WV 25301-2835
(681) 313-1759
(844) 800-3954
Mailing address
505 55TH ST UNIT B, VIENNA, WV 26105-3215
(681) 313-1759
(844) 800-3954
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
42618
WV
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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