DR. Bradley Mart Lane, OD

NPI #1255539607 in Pearisburg, Virginia

Provider Information

NPI Number: 1255539607
Entity Type: Individual
Name: DR. Bradley Mart Lane, OD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jul 6, 2007
Last Updated: May 25, 2011

Practice Location

Address: 700 WENONAH AVE
City: Pearisburg
State: Virginia
ZIP Code: 24134-1638
Phone: (540) 921-4116

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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