Individual
LORA A MIZE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
701 REEDY RD, CONWAY, AR 72034-9383
(870) 612-4412
Mailing address
3300 RIVERMONT AVE, OUTPATIENT THERAPY ADMINISTRATION, LYNCHBURG, VA 24503
(434) 200-5032
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2770
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154741721
—
AR
Enumeration date
10/28/2005
Last updated
11/08/2016
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