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Individual

CARLY M. LOHSTRETER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3165 DEMERS AVE, GRAND FORKS, ND 58201-4049
(701) 780-6623
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11452
MN
363A00000X
Physician Assistant
52399
CA
363A00000X
Physician Assistant
Primary
PAC0751
ND

Other

Enumeration date
10/31/2013
Last updated
11/15/2018
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