Provider Demographics
NPI:1922771203
Name:LISA M BUTTERFIELD, OD, LLC
Entity Type:Organization
Organization Name:LISA M BUTTERFIELD, OD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-715-1421
Mailing Address - Street 1:2316 WILDWOOD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:AMISSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20106-1884
Mailing Address - Country:US
Mailing Address - Phone:630-715-1421
Mailing Address - Fax:
Practice Address - Street 1:2017 S LOUDOUN ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3612
Practice Address - Country:US
Practice Address - Phone:540-665-0571
Practice Address - Fax:540-667-7439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LISA M BUTTERFIELD, OD, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-31
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier