Provider Demographics
NPI:1962522847
Name:LO, A. HING-LAN (LIC AC)
Entity type:Individual
Prefix:
First Name:A. HING-LAN
Middle Name:
Last Name:LO
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:LAN
Other - Last Name:GASSERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICAC
Mailing Address - Street 1:191 SUDBURY RD
Mailing Address - Street 2:STE 36
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3467
Mailing Address - Country:US
Mailing Address - Phone:978-831-3708
Mailing Address - Fax:
Practice Address - Street 1:191 SUDBURY RD
Practice Address - Street 2:STE 36
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3467
Practice Address - Country:US
Practice Address - Phone:978-831-3708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216172171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist