Individual
DR. JUSTIN DAVID LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1345 WESTERN BLVD STE 120B, JACKSONVILLE, NC 28546-7627
(910) 376-8229
Mailing address
120 WYNDHAM WAY, WILMINGTON, NC 28411-6710
(910) 508-4127
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2030
NC
Other
Enumeration date
02/12/2007
Last updated
11/27/2016
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