Individual
DR. LISA MARTIN WIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1809 CORLIES AVE, SUITE 1, NEPTUNE, NJ 07753-4801
(732) 774-5566
(732) 988-7574
Mailing address
1809 CORLIES AVE, SUITE 1, NEPTUNE, NJ 07753-4801
(732) 774-5566
(732) 988-7574
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OA00516100
NJ
Other
Enumeration date
08/31/2006
Last updated
12/09/2010
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