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NPI Code Detail

MEDICARE: KRISTIN LORENCE

MEDICARE: KRISTIN LORENCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist62 036720NY

General Provider Information

NPI Number : 1659777001
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN LORENCE
Provider Business Mailing Address
First Line : 7740 MEIGS RD
Second Line :
City : BALDWINSVILLE
State : NY
Zip : 13027-9757
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7740 MEIGS RD
Second Line :
City : BALDWINSVILLE
State : NY
Zip : 13027-9757
Country : US
Telephone Number : 315-638-2521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2014
Last Update Date : 11/12/2014

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Directions to “ KRISTIN LORENCE ” Practice Location

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