Doctor Name: | LISA CUDA MCCARRON |
NPI Number: | 1053553453 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 5500 E Cheryl Pkwy Suite 103 Fitchburg, WI - 537115336 |
Business Phone Number: | 6082733937 |
Business Fax Number: | |
Mailing Address: | 8417 Dolomite Ln, MADISON |
State: | WI |
Postal Code: | 537194614 |
Phone Number: | 6088481737 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2009 |
NPI Last Update Date: | 03/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |