Provider Demographics
NPI:1326277138
Name:LANSINK, LISA (OD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:LANSINK
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:4100 UNIVERSITY AVE
Mailing Address - Street 2:#106
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5956
Mailing Address - Country:US
Mailing Address - Phone:515-224-1317
Mailing Address - Fax:515-224-6069
Practice Address - Street 1:4100 UNIVERSITY AVE
Practice Address - Street 2:#106
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5956
Practice Address - Country:US
Practice Address - Phone:515-224-1317
Practice Address - Fax:515-224-6069
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2011-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA002454152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist