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NPI 1457443491

NPI 1457443491 : LISA B. DANIEL O.D. : AUBURN, AL

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General NPI Number Information
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    NPI Number           |    1457443491
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    Entity Type          |    Individual 
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    Provider Name        |    LISA B. DANIEL O.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/28/2006
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    Last Update Date     |    08/20/2019
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Provider Practice Location Address
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    Address Line         |    1955 OPELIKA RD 
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    City                 |    AUBURN
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    State                |    AL
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    Zip                  |    36830-2811
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    Country              |    US
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    Telephone            |    334-821-8889
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    Fax                  |    334-821-4733
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Provider Business Mailing Address
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    Address Line         |    2080 BERRYHILL RD 
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    City                 |    MONTGOMERY
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    State                |    AL
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    Zip                  |    36117-3599
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    Country              |    US
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    Telephone            |    334-387-2020
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    Fax                  |    334-387-0449
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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       |    S827TA355
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    License Number State |    AL
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