Organization
JOEY L. LANE OPTOMETRIST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEY L. LANE OD (OWNER)
(717) 485-4434
Entity
Organization
Contact information
Practice address
182 BUCHANAN TRAIL, SUITE 185, MCCONNELLSBURG, PA 17233-8261
(717) 485-4434
(717) 485-9407
Mailing address
PO BOX 697, MCCONNELLSBURG, PA 17233-0697
(717) 485-4434
(717) 485-9407
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000013
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021216990001
—
PA
01
—
2020813
HIGHMARK BLUE SHIELD
PA
01
—
50075088
CAPITAL BLUE CROSS
PA
Enumeration date
02/05/2008
Last updated
09/21/2011
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