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General NPI Number Information
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NPI Number | 1427052125
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Entity Type | Individual
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Provider Name | CHERIE S LODL O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 2510 S 171ST CT
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City | OMAHA
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State | NE
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Zip | 68130-2394
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Country | US
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Telephone | 402-330-3063
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Fax | 402-334-4418
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Provider Business Mailing Address
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Address Line | 2510 S 171ST CT
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City | OMAHA
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State | NE
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Zip | 68130-2394
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Country | US
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Telephone | 402-330-3063
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Fax | 402-334-4418
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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 | 1042
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License Number State | NE
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