Individual
MAI S LOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1480 CONCORD PKWY N STE 350, CONCORD, NC 28025-0121
(980) 781-9251
Mailing address
1480 CONCORD PKWY N STE 350, CONCORD, NC 28025-0121
(980) 781-9251
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
000031166278
NC
172A00000X
Driver
000037366685
NC
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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