=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417920596
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET T LOMASNEY OD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2006
-----------------------------------------------------
Last Update Date | 08/10/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1612 TENTH AVE
-----------------------------------------------------
City | PORT HURON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48060
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-966-1950
-----------------------------------------------------
Fax | 810-966-1952
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1612 TENTH AVE
-----------------------------------------------------
City | PORT HURON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48060
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-966-1950
-----------------------------------------------------
Fax | 810-966-1952
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 4901003780
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------