Lifetime Vision Source of Lebanon LLC

NPI #1710168877 in Lebanon, Oregon

Provider Information

NPI Number: 1710168877
Entity Type: Organization
Organization Name: Lifetime Vision Source of Lebanon LLC
Primary Specialty: Optometrist
Enumeration Date: Nov 16, 2007
Last Updated: Dec 2, 2008

Practice Location

Address: 90 MARKET ST
Address 2: STE 20
City: Lebanon
State: Oregon
ZIP Code: 97355-2394
Phone: (541) 451-1144

Authorized Official

Name: TERESA TURRENTINE
Title: ADMINISTRATIVE ASSISTANT
Phone: (541) 451-1144

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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