Individual
LISA R PRADILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1501 DEREK DR, HAMMOND, LA 70403-5745
(985) 345-0607
(985) 345-0490
Mailing address
1501 DEREK DR, HAMMOND, LA 70403-5745
(985) 345-0607
(985) 345-0490
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1415-555T
LA
Other
Enumeration date
07/09/2006
Last updated
12/08/2022
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