Individual
LEANNA A OLENNIKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
198 N MAIN ST, RUTLAND, VT 05701-3020
(802) 775-2368
(802) 775-2369
Mailing address
198 N MAIN ST, RUTLAND, VT 05701-3020
(802) 775-2368
(802) 775-2369
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
030.0133921
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275885501
—
VA
01
—
4701609
CIGNA
VA
01
—
548085
ANTHEM BCBS
VA
Enumeration date
10/10/2012
Last updated
01/15/2020
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