Individual
ORLY LEIVA LAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1920 GUENTHER RD, DAYTON, OH 45417-9404
(937) 732-6034
Mailing address
1920 GUENTHER RD, DAYTON, OH 45417-9404
(937) 732-6034
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
5718445
OH
Other
Enumeration date
12/14/2020
Last updated
09/08/2023
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