Lagassa, Lisa Renee

Lagassa, Lisa Renee is an individual health care provider with primary practice located at 20525 Mack Ave , Grosse Pointe Woods MI 48236-1655. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Lagassa, Lisa Renee can be contacted via phone (313) 881-6622.

Contact Information

Primary practice address
20525 Mack Ave Grosse Pointe Woods MI 48236-1655
Phone: (313) 881-6622
Fax: (313) 881-9380
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901003663 Michigan

Profile Details

NPI number 1720076375
LBN Legal business name Lagassa, Lisa Renee
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2005
Last updated Feb 15th, 2024 - about 7 months 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 1720076375 NPPES
Michigan Other 204683 COLE PROVIDER #
Michigan Other 90-0-H2-2311-0 COLE PROVIDER #

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