Organization
LIFETIME VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA GORE O.D. (DOCTOR)
(870) 633-1174
Entity
Organization
Contact information
Practice address
330 DILLARD AVE, FORREST CITY, AR 72335-3260
(870) 633-1174
(870) 633-3838
Mailing address
330 DILLARD AVE, FORREST CITY, AR 72335-3260
(870) 633-1174
(870) 633-3838
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106007722
—
AR
Enumeration date
09/20/2006
Last updated
05/20/2008
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