Individual
MRS. LORI CROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1621 N CEDAR CREST BLVD, ALLENTOWN, PA 18104-2304
(610) 402-8900
(610) 402-5623
Mailing address
1605 N CEDAR CREST BLVD, ALLENTOWN, PA 18104-2351
(484) 884-0617
(484) 884-0628
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA051135
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA051135
STATE LICENSE
PA
Enumeration date
07/07/2006
Last updated
05/05/2022
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