Provider Demographics
NPI:1912608316
Name:RANES, LISA J
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:J
Last Name:RANES
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 1:2925 GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2684
Mailing Address - Country:US
Mailing Address - Phone:419-380-8769
Mailing Address - Fax:419-380-8921
Practice Address - Street 1:2925 GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2684
Practice Address - Country:US
Practice Address - Phone:419-380-8769
Practice Address - Fax:419-380-8921
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician