La Susa, Lisa

La Susa, Lisa is an sole proprietor health care provider with primary practice located at 1437 S Main St , West Bend WI 53095-4931. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. La Susa, Lisa can be contacted via phone (262) 334-1925.

Contact Information

Primary practice address
1437 S Main St West Bend WI 53095-4931
Phone: (262) 334-1925
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3336-35 Wisconsin
Eye and Vision Services Providers / Optometrist 152W00000X 8496T Texas

Profile Details

NPI number 1730593310
LBN Legal business name La Susa, Lisa
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 11th, 2014
Last updated Jun 11th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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