Provider Demographics
NPI:1801522388
Name:ALLEN, LANCE (LAC)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:233 W PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-5430
Mailing Address - Country:US
Mailing Address - Phone:910-692-8049
Mailing Address - Fax:910-246-2225
Practice Address - Street 1:233 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5430
Practice Address - Country:US
Practice Address - Phone:910-692-8049
Practice Address - Fax:910-246-2225
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC183171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist