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General NPI Number Information
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NPI Number | 1477680015
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Entity Type | Organization
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Legal Business Name | PAUL W LANCZKI PC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 1136 COUNTRY CLUB RD SUITE C
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City | ADRIAN
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State | MI
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Zip | 49221-8208
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Country | US
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Telephone | 517-265-6055
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Fax | 517-265-6115
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Provider Business Mailing Address
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Address Line | 1136 COUNTRY CLUB RD SUITE C
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City | ADRIAN
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State | MI
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Zip | 49221-8208
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Country | US
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Telephone | 517-265-6055
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Fax | 517-265-6115
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. CONSTANCE MUCK
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Credential |
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Telephone | 517-265-6055
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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 | 4901004286
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002974
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License Number State | MI
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