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Individual

DR. LISA B CHILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1235 E HARMONT DR, PHOENIX, AZ 85020-3864
(602) 331-1470
(602) 678-5819
Mailing address
1235 E HARMONT DR, PHOENIX, AZ 85020-3864
(602) 331-1470
(602) 678-5819

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618001146
VA
152W00000X
Optometrist
Primary
1575
AZ
152WL0500X
Low Vision Rehabilitation Optometrist
1575
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010073685
VA
Enumeration date
03/17/2006
Last updated
02/12/2024
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