Individual
LORI HUSKINS BALMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3103 OCOEE ST N, CLEVELAND, TN 37312-5381
(423) 479-4174
Mailing address
3103 OCOEE ST N, CLEVELAND, TN 37312-5381
(423) 479-4174
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD1572
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1119050001
MEDICARE PALMETTO GOVERNM
TN
01
—
2240040
UNITED HEALTH CARE
TN
01
—
3036748
BLUE CROSS BLUE SHIELD
TN
01
—
6985019
CIGNA
TN
Enumeration date
06/15/2006
Last updated
03/14/2012
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