Lisa La Susa O.D.

NPI 1730593310 - Optometrist - 152W00000X

NPI Details
NPI 1730593310
Gender Female
Enumeration Date 06/11/2014
Last Updated 06/11/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
1437 S MAIN ST
WEST BEND WI, 53095-4931, US
Phone (262) 334-1925
Fax
Business Location
1437 S MAIN ST
WEST BEND WI, 53095-4931, US
Phone
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Texas
License Number 8496T
Remove 1730593310 NPI Number
 

According to our database, Lisa La Susa O.D. NPI is 1730593310, taxonomy code is 152W00000X and license number is 8496T, license state is located at Texas. Lisa La Susa O.D. physically located at 1437 S Main St, West Bend WI, 53095-4931. NPI Number Lisa La Susa O.D. has the Individual type.

Sponsored links

1730593310 NPI number is provided on an as is basis without warranty of any kind. 1730593310 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa La Susa O.D. are for informational purposes only.