Individual
DR. LANCE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1400 N WAYNE ST STE D, ANGOLA, IN 46703-2359
(260) 668-8881
(260) 665-6498
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004017A
IN
Other
Enumeration date
09/22/2015
Last updated
07/11/2023
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