John Lackey, INC
NPI #1609904663 in Summersville, West Virginia
Provider Information
- NPI Number
- 1609904663
- Entity Type
- Organization
- Organization Name
- John Lackey, INC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- Mar 1, 2007
- Last Updated
- Nov 3, 2011
Practice Location
- Address
- 702 PROFESSIONAL PARK DR
- Address 2
- SUITE102
- City
- Summersville
- State
- West Virginia
- ZIP Code
- 26651-2018
- Phone
- (304) 872-6433
Authorized Official
- Name
- DR. JOHN LACKEY, D.O.
- Title
- OWNER
- Phone
- (304) 872-6433
Specialties & Taxonomy Codes
| Specialty |
|---|
| Eyewear Supplier |
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