Individual
MRS. LORA EWANKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 N BEELINE HWY, PAYSON, AZ 85541-4305
(928) 472-2826
(928) 472-2815
Mailing address
300 N BEELINE HWY, PAYSON, AZ 85541-4305
(928) 472-2826
(928) 472-2815
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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