Individual
LANE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2623 E GULF TO LAKE HWY, INVERNESS, FL 34453-3216
(352) 637-5180
Mailing address
270 S THAYER AVE, LECANTO, FL 34461-8657
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO4314
FL
Other
Enumeration date
05/03/2007
Last updated
07/09/2007
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