Individual
BETH WINIFRED LORENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
984 WHITTIER HIGHWAY, MOULTONBOROUGH, NH 03254
(603) 476-2216
(603) 476-5396
Mailing address
PO BOX 655, MOULTONBORO, NH 03254-0655
(603) 253-3178
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0210P
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30331636
—
NH
Enumeration date
07/19/2005
Last updated
10/22/2012
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