Individual
LORI A SANSONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4881 SUGAR MAPLE DR, 88TH MDOS/SGOPC, WPAFB, OH 45433-5546
(937) 257-9700
Mailing address
4881 SUGAR MAPLE DR, 88TH MDOS/SGOPC, WPAFB, OH 45433-5546
(937) 257-9700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
035-049165
OH
Other
Enumeration date
10/28/2005
Last updated
10/07/2008
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