Provider Demographics
NPI:1689356867
Name:CORLE, LINDSAY BRIANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:BRIANNE
Last Name:CORLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:LINDSAY
Other - Middle Name:BRIANNE
Other - Last Name:OVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 OLDE FARM OFFICE RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-9417
Mailing Address - Country:US
Mailing Address - Phone:814-695-3141
Mailing Address - Fax:814-696-4780
Practice Address - Street 1:108 OLDE FARM OFFICE RD
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-9417
Practice Address - Country:US
Practice Address - Phone:814-695-3141
Practice Address - Fax:814-696-4780
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG004058152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist