Individual
PAO CHOUA LOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4552 MEADOW WY, OLIVEHURST, CA 95961
(530) 923-2136
Mailing address
4552 MEADOW WAY, OLIVEHURST, CA 95961-4527
(530) 455-5440
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
11/19/2008
Last updated
12/18/2009
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