Individual
KOUA LOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 MEMORIAL DR, TWO RIVERS, WI 54241-3900
(920) 794-5000
Mailing address
5000 MEMORIAL DR, TWO RIVERS, WI 54241-3900
(920) 794-5000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5558-26
WI
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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