Provider Demographics
NPI:1679753107
Name:LO-VANG, PAZIONG ESTELLE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:PAZIONG
Middle Name:ESTELLE
Last Name:LO-VANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 DUNLAP ST N STE 302
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4207
Mailing Address - Country:US
Mailing Address - Phone:651-214-5657
Mailing Address - Fax:651-493-4682
Practice Address - Street 1:393 DUNLAP ST N STE 302
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4207
Practice Address - Country:US
Practice Address - Phone:651-214-5657
Practice Address - Fax:651-493-4682
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1403171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist