Individual
LISA STEWARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4684 S US HIGHWAY 41, TERRE HAUTE, IN 47802-5404
(812) 223-4925
Mailing address
4684 S US HIGHWAY 41, TERRE HAUTE, IN 47802-5404
(812) 223-4925
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003349A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20052770A
—
IN
01
—
28125
SPECTERA
IN
Enumeration date
08/13/2006
Last updated
07/08/2010
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