Individual
ALEXIS LOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
23 W SCOTT ST, FOND DU LAC, WI 54935-2342
(920) 926-0101
Mailing address
23 W SCOTT ST, FOND DU LAC, WI 54935
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
235444-30
WI
Other
Enumeration date
08/14/2015
Last updated
08/20/2021
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