Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT0003161 | CO |
NPI | 1003120445 |
---|---|
Provider Name | Lisa M Schneider |
First Address | Fort Collins, CO 80526-5563 |
Second Address | Fort Collins, CO 80526-5563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2010 |
Last Update Date | 24/07/2017 |