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Individual

J LANCASTER ROSE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
435 CEDAR ST, LEWISBURG, TN 37091-3351
(931) 359-1467
Mailing address
435 CEDAR ST, LEWISBURG, TN 37091-3351

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000001122
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0077625
BCBS
TN
05
3596313
TN
Enumeration date
08/16/2005
Last updated
04/02/2008
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