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General NPI Number Information
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NPI Number | 1255676292
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Entity Type | Organization
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Legal Business Name | DR. M. STANLEY LANWAY & ASSOCIATES
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 6575 FRONTIER DR SUITE N
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City | SPRINGFIELD
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State | VA
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Zip | 22150-1415
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Country | US
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Telephone | 703-971-7722
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Fax | 703-971-1724
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Provider Business Mailing Address
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Address Line | 6575 FRONTIER DR SUITE N
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City | SPRINGFIELD
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State | VA
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Zip | 22150-1415
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Country | US
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Telephone | 703-971-7722
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Fax | 703-971-1724
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MERLE STANLEY LANWAY
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Credential | O.D.
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Telephone | 703-971-7722
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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 | 0618000503
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License Number State | VA
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