Individual
DR. JOHN LAWRENCE MOONAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
860 SUMMIT CROSSING PL STE 110, GASTONIA, NC 28054-2217
(704) 865-3937
(704) 865-8851
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1907
SC
152W00000X
Optometrist
Primary
2444
NC
Other
Enumeration date
11/15/2015
Last updated
02/05/2024
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