Visa Lahang Avance, OTA

NPI #1215176466 in Jonesboro, Arkansas

Provider Information

NPI Number: 1215176466
Entity Type: Individual
Name: Visa Lahang Avance, OTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: OTA
Enumeration Date: Feb 11, 2009
Last Updated: Feb 11, 2009

Practice Location

Address: 1656 W MATTHEWS AVE APT 5
City: Jonesboro
State: Arkansas
ZIP Code: 72401-3311
Phone: (870) 995-4202

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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