Individual
DR. JUSTIN LANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 PONDER CT, DANVILLE, KY 40422
(859) 236-4852
Mailing address
PO BOX 990, DANVILLE, KY 40423-0990
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R3832
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2015
Last updated
01/16/2019
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