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Individual

VIVIAN SZE TING LO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O

Contact information

Practice address
4250 BETHEL RD, OLIVE BRANCH, MS 38654-8737
(662) 932-9111
Mailing address
695 ROBERTSON WAY, HERNANDO, MS 38632-2233
(870) 394-6430

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
22451
MS
207R00000X
Internal Medicine Physician
Primary
22451
MS
207R00000X
Internal Medicine Physician
2349
TN

Other

Enumeration date
04/06/2010
Last updated
05/12/2016
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