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Individual
LANCE ROGER OLDORF
Active
Individual
LANCE ROGER OLDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
109718
IA
363A00000X
Physician Assistant
2099
TN
363A00000X
Physician Assistant
PA.1011
AL
Other
Enumeration date
06/04/2009
Last updated
05/02/2022
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