Provider Demographics
NPI:1386783207
Name:LEVENSALER, LAURA L (RN LAC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:L
Last Name:LEVENSALER
Suffix:
Gender:F
Credentials:RN LAC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:LAROCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 REVERE RD
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-4729
Mailing Address - Country:US
Mailing Address - Phone:781-891-7587
Mailing Address - Fax:781-933-1389
Practice Address - Street 1:751 MAIN ST
Practice Address - Street 2:SUITE 5 ACUPUNCTURE PLUS INC
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-0620
Practice Address - Country:US
Practice Address - Phone:781-891-7587
Practice Address - Fax:781-933-1389
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist