Provider Demographics
NPI:1356071476
Name:BATTS, LORI LEIGH (ST LICENSED OPTICIAN)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:LEIGH
Last Name:BATTS
Suffix:
Gender:F
Credentials:ST LICENSED OPTICIAN
Other - Prefix:MRS
Other - First Name:LORI
Other - Middle Name:L
Other - Last Name:BATTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ST LICENSED OPTICIAN
Mailing Address - Street 1:1225 PARIS RD # 430
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-4989
Mailing Address - Country:US
Mailing Address - Phone:270-247-6262
Mailing Address - Fax:270-247-8652
Practice Address - Street 1:1225 PARIS RD # 430
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-4989
Practice Address - Country:US
Practice Address - Phone:270-247-6262
Practice Address - Fax:270-247-8652
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY111705156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician