Dr. Lisa Wadolowski Koehler, OD
Optometrist in Memphis, TN. Individual provider (NPI-1).
NPI number1164094702
StatusActive
Last updated in NPPESNov 1, 2024
Details
- NPI
- 1164094702
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lisa Wadolowski Koehler
- Credential
- OD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 13, 2021
- Certification date
- Nov 1, 2024
- Last updated
- Nov 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 009354 | NY | Yes |
Practice location
1225 Madison AveMemphis, TN 38104-2211
Phone 901-722-3250
Mailing address
1245 Madison AveMemphis, TN 38104-2211
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