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General NPI Number Information
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NPI Number | 1033307210
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Entity Type | Individual
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Provider Name | CYNTHIA LANG
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Gender | Female
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 400 E NATIONAL HWY
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City | WASHINGTON
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State | IN
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Zip | 47501-4114
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Country | US
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Telephone | 812-254-6594
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Fax |
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Provider Business Mailing Address
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Address Line | 2585 S 500 E
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City | MONTGOMERY
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State | IN
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Zip | 47558-5482
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18002281A
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License Number State | IN
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