Porter, Lisa L.
Porter, Lisa L. is an sole proprietor health care provider with primary practice located at 1480 E Lincoln Rd Ste B , Idaho Falls ID 83401-2128. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Porter, Lisa L. can be contacted via phone (208) 525-8686.Contact Information
Primary practice address
1480 E Lincoln Rd Ste B
Idaho Falls ID 83401-2128
Phone: (208) 525-8686
Fax: (208) 525-8684
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-10013 | Idaho |
Profile Details
| NPI number | 1215962915 |
|---|---|
| LBN Legal business name | Porter, Lisa L. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Nov 11th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215962915 | NPPES |
| Idaho | MEDICAID | 000807525000 |
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