Individual
DR. AMANDA L LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5959 LAWNDALE ST, LUDINGTON, MI 49431-2921
(231) 845-6261
(231) 843-9171
Mailing address
5959 LAWNDALE ST, LUDINGTON, MI 49431-2921
(231) 845-6261
(231) 843-9171
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
004110
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4620819
—
MI
05
—
4620828
—
MI
05
—
4921634
—
MI
01
—
900F410030
BCBS OF MICHIGAN
—
01
—
P00138760
RAILROAD MEDICARE
—
Enumeration date
01/25/2006
Last updated
11/02/2011
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