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Individual

MR. JOSHUA J LANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
45075 W PONTIAC TRL, NOVI, MI 48377-1257
(248) 960-5600
(248) 960-8049
Mailing address
45075 W PONTIAC TRL, NOVI, MI 48377-1257
(313) 366-5100
(313) 366-2246

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004248
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4637018
MI
Enumeration date
10/12/2006
Last updated
11/07/2020
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