Moffitt, Lisa

Moffitt, Lisa is an individual health care provider with primary practice located at 16086 Conneaut Lake Rd Walmart Vision Center, Meadville PA 16335-3884. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Moffitt, Lisa can be contacted via phone (816) 337-4426.

Contact Information

Primary practice address
16086 Conneaut Lake Rd Walmart Vision Center Meadville PA 16335-3884
Phone: (816) 337-4426
Fax: (814) 337-4320
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X PA0EG000769 Pennsylvania

Profile Details

NPI number 1104833615
LBN Legal business name Moffitt, Lisa
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Dec 1st, 2016 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1104833615 NPPES
Pennsylvania Other 0000027186 MEDICARE
Pennsylvania Other 376852 MEDICARE
Pennsylvania Other 001746361 0003 MEDICARE
Pennsylvania Other 0017463610003 MEDICARE
Pennsylvania Other 52269 MEDICARE

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