Provider Demographics
NPI:1700334752
Name:ASMAN, LISA M (OD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:ASMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:PELZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1350 SE UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8933
Mailing Address - Country:US
Mailing Address - Phone:515-987-3937
Mailing Address - Fax:515-330-3427
Practice Address - Street 1:1350 SE UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8933
Practice Address - Country:US
Practice Address - Phone:515-987-3937
Practice Address - Fax:515-330-3427
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086025152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist