Individual
LISA OCONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTRL
Contact information
Practice address
2410 LORD ANSON DR, WAXHAW, NC 28173-6808
(704) 651-5148
(704) 243-6137
Mailing address
2410 LORD ANSON DR, WAXHAW, NC 28173-6808
(704) 651-5148
(704) 243-6137
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
5842
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7301855
—
NC
Enumeration date
07/17/2006
Last updated
07/09/2007
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