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1134999519
LORA EWANKO
PAYSON, AZ
NPI
1134999519
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Former Name
LORA CHASTAIN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
156FX1800X Technician/Technologist, Optician
Enumeration Date
2024-01-05
Last Update Date
2024-01-05
Business Address
Mrs. LORA EWANKO
300 N BEELINE HWY
PAYSON, AZ 85541-4305
Phone number: 928-472-2826
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Mailing Address
Mrs. LORA EWANKO
300 N BEELINE HWY
PAYSON, AZ 85541-4305
Phone number: 928-472-2826
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