Individual
MS. LORI L SUSDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3552 HWY K EAST, CONOVER, WI 54519
(715) 479-6699
Mailing address
3552 COUNTY ROAD K, CONOVER, WI 54519
(715) 479-6699
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
87927-30
WI
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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