Individual
DANICA MALEINE LANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
171318
AK
152W00000X
Optometrist
18003619A
IN
152W00000X
Optometrist
1933DT
KY
152W00000X
Optometrist
4901004551
MI
152W00000X
Optometrist
5914
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000660241
ANTHEM
IN
01
—
0G50032
BCBSM
MI
Enumeration date
10/05/2009
Last updated
04/01/2021
Update your record
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