Individual
MS. LISA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
4054 COMMONWEATH AVE, EAU CLAIRE, WI 54701-9000
(715) 833-1220
(715) 833-1297
Mailing address
4054 COMMONWEATH AVE, EAU CLAIRE, WI 54701-9000
(715) 833-1220
(715) 833-1297
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38460300
—
WI
Enumeration date
07/08/2008
Last updated
07/08/2008
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