Individual
MISS MISTY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
324 OAKVALE RD STE 100, PRINCETON, WV 24740-3829
(304) 425-2444
(304) 425-2446
Mailing address
324 OAKVALE RD STE 100, PRINCETON, WV 24740-3829
(304) 425-2444
(304) 425-2446
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2048-IOD
WV
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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