Individual
LORA BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2105 E SOUTH BLVD, MONTGOMERY, AL 36116-2409
(334) 213-6255
Mailing address
14050 NW 14TH ST STE 190, SUNRISE, FL 33323-2851
(800) 424-3672
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TA1776
AL
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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