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General NPI Number Information
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NPI Number | 1205491941
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Entity Type | Individual
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Provider Name | CORY JEAN LAWRENCE-FISHER O.D.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | NAVAL HEALTH CLINIC LEMOORE 937 FRANKLIN AVE
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City | LEMOORE
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State | CA
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Zip | 93245
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Country | US
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Telephone | 559-998-2649
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Fax |
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Provider Business Mailing Address
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Address Line | NMRTC LEMOORE - OPTOMETRY DEPARTMENT 937 FRANKLIN AVE.
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City | LEMOORE
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State | CA
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Zip | 93246
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | SE33TAB59
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License Number State | AL
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