Provider Demographics
NPI:1205491941
Name:LAWRENCE-FISHER, CORY JEAN (OD)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:JEAN
Last Name:LAWRENCE-FISHER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NMRTC LEMOORE - OPTOMETRY DEPARTMENT
Mailing Address - Street 2:937 FRANKLIN AVE.
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93246
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HEALTH CLINIC LEMOORE
Practice Address - Street 2:937 FRANKLIN AVE
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245
Practice Address - Country:US
Practice Address - Phone:559-998-2649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSE33TAB59152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist