Organization
LIS CORPORATION
Active
Other names
CRYSTAL VISION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEWIS LISSES OD (PRESIDENT)
(570) 288-7471
Entity
Organization
Contact information
Practice address
1018 WYOMING AVE, WYOMING, PA 18644-1331
(570) 288-7471
(570) 288-8142
Mailing address
1018 WYOMING AVE, WYOMING, PA 18644-1331
(570) 288-7471
(570) 288-8142
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0896140001
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053382994
NPI INDIVIDUAL
PA
01
—
1891849063
NPI GROUP
PA
Enumeration date
01/23/2007
Last updated
07/02/2012
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