Individual
LEAH LENTZ HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
6 S 14TH ST, FERNANDINA, FL 32034
(904) 261-5741
(904) 261-7383
Mailing address
6 S 14TH ST, FERNANDINA, FL 32034-3212
(904) 261-5741
(904) 261-7383
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5332
FL
152W00000X
Optometrist
OPT002938
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14TH
BUSINESS ADRESS
—
Enumeration date
06/09/2016
Last updated
01/07/2019
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