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Individual

SANDRA JEAN TIERNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
WALMART, 1275 E 2ND STREET, FRANKLIN, OH 45005
(937) 704-0809
(937) 704-0820
Mailing address
1947 MEADOWSWEET DR, LEBANON, OH 45036-4077
(419) 654-4138

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
OP.017188-SC
OH

Other

Enumeration date
02/16/2023
Last updated
02/16/2023
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