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Individual

LORRAINE BOHANSKE POSSANZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.P.M.

Contact information

Practice address
1246 W MAIN ST, NORRISTOWN, PA 19401-4365
(610) 272-6554
Mailing address
418 HOMESTEAD DR, WEST CHESTER, PA 19382-8242

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
SC 002693-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04 0971585
PA
01
BO 102324
BLUE SHIELD
Enumeration date
03/05/2010
Last updated
03/05/2010
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