Individual
DR. LORRY WAYNE LAZENBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2318 E 32ND ST STE A, JOPLIN, MO 64804-4326
(417) 206-0399
(417) 206-0567
Mailing address
2318 E 32ND ST STE A, JOPLIN, MO 64804-4326
(417) 206-0399
(417) 206-0567
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2703
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200914664
TAX I.D. #
MO
Enumeration date
09/20/2006
Last updated
10/02/2018
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