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General NPI Number Information
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NPI Number | 1003089731
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Entity Type | Organization
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Legal Business Name | J LANCASTER ROSE JR
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 435 CEDAR ST
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City | LEWISBURG
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State | TN
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Zip | 37091-3351
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Country | US
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Telephone | 931-359-1467
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Fax |
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Provider Business Mailing Address
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Address Line | 435 CEDAR ST
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City | LEWISBURG
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State | TN
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Zip | 37091-3351
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | J LANCASTER ROSE JR.
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Credential |
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Telephone | 931-359-1467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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