Individual
LEANNE M LIDDICOAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
114 N SUNRISE AVE, SUITE C2, ROSEVILLE, CA 95661-2916
(916) 786-2212
(916) 786-2393
Mailing address
114 N SUNRISE AVE, SUITE C2, ROSEVILLE, CA 95661-2916
(916) 786-2212
(916) 786-2393
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
11076T
CA
Other
Enumeration date
09/29/2006
Last updated
11/08/2010
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