Individual
THAO LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2727 PLAZA DR, WAUSAU, WI 54401
(715) 847-3000
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3076-23
WI
Other
Enumeration date
02/20/2013
Last updated
05/09/2024
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