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General NPI Number Information
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NPI Number | 1467924563
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Entity Type | Individual
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Provider Name | LORA L NANCE ASSOCIATES
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Gender | Female
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Dates
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Enumeration Date | 12/30/2018
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Last Update Date | 12/30/2018
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Provider Practice Location Address
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Address Line | 1502 E CENTENNIAL DR
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City | PITTSBURG
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State | KS
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Zip | 66762-6718
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Country | US
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Telephone | 620-253-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 2002 SW 70TH TER
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City | TOPEKA
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State | KS
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Zip | 66619-1250
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 18-01549
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License Number State | KS
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