Individual
LORI LISTZWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14296 NW 161ST AVE, ALACHUA, FL 32615-9206
(352) 283-1665
Mailing address
14296 NW 161ST AVE, ALACHUA, FL 32615-9206
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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