Individual
MS. MANDY LYNNETTE LANIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
610 STATE FARM RD, SUITE A, BOONE, NC 28607-4738
(828) 264-0042
(828) 264-8612
Mailing address
610 STATE FARM RD, SUITE A, BOONE, NC 28607-4738
(828) 264-0042
(828) 264-8612
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1982
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0853510001
CIGNA GOVERNMENT SERVICES MEDICARE PART B DME
NC
01
—
093T4
BCBS
NC
01
—
410034018
RRMC
NC
05
—
5901497
—
NC
Enumeration date
02/15/2007
Last updated
11/25/2014
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