Healthcare Provider Details

I. General information

NPI: 1598940132
Provider Name (Legal Business Name): LAUREL TURK LIC. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 N MAIN ST
SUNDERLAND MA
01375-9574
US

IV. Provider business mailing address

PO BOX 43
SUNDERLAND MA
01375-0043
US

V. Phone/Fax

Practice location:
  • Phone: 413-665-9077
  • Fax:
Mailing address:
  • Phone: 413-665-9077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number526
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: