Individual
LAN T LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
10509 HEARTLAND BLVD, CAMBY, IN 46113-9123
(317) 821-8850
(317) 821-8850
Mailing address
8783 MEDORA DR, APT 2F, CAMBY, IN 46113-8392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003621A
IN
Other
Enumeration date
12/10/2009
Last updated
12/10/2009
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