Koua Lor

NPI #1982075420 in Two Rivers, Wisconsin

Provider Information

NPI Number: 1982075420
Entity Type: Individual
Name: Koua Lor
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Enumeration Date: Oct 9, 2015
Last Updated: Oct 9, 2015

Practice Location

Address: 5000 MEMORIAL DR
City: Two Rivers
State: Wisconsin
ZIP Code: 54241-3900
Phone: (920) 794-5000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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