Individual
BETHANY RACINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
72 PROSPECT ST, GILBERTVILLE, MA 01031-9704
(774) 230-4983
Mailing address
72 PROSPECT ST, GILBERTVILLE, MA 01031-9704
(774) 230-4983
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN101038
MA
Other
Enumeration date
10/25/2022
Last updated
10/25/2022
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