Individual
KOU LO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7925 WOODSHIVE DR, MABELVALE, AR 72103-2903
(501) 940-1889
Mailing address
7925 WOODSHIVE DR, MABELVALE, AR 72103-2903
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R80451
AR
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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