Individual
LORI GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
423 GREAT OAK DR, WAITE PARK, MN 56387-2507
(218) 287-4338
Mailing address
1547 30TH AVE S, MOORHEAD, MN 56560-5149
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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