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Individual

DR. JACK D. LAWRENCE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
150 MARKET HILLS DR, BOONE, NC 28607-3678
(828) 262-1554
(828) 268-2981
Mailing address
150 MARKET HILLS DR, BOONE, NC 28607-3678
(828) 262-1554
(828) 268-2981

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0889
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09519
BCBS
05
89-09519
NC
Enumeration date
07/06/2005
Last updated
06/17/2008
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