Provider Demographics
NPI:1497447551
Name:TURNER, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 E LYNCHBURG SALEM TPKE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-3446
Mailing Address - Country:US
Mailing Address - Phone:540-586-6591
Mailing Address - Fax:540-586-6954
Practice Address - Street 1:1126 E LYNCHBURG SALEM TPKE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-3446
Practice Address - Country:US
Practice Address - Phone:540-586-6591
Practice Address - Fax:540-586-6954
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101004512156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician