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General NPI Number Information
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NPI Number | 1689553901
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Entity Type | Individual
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Provider Name | MICHAELA LASSA LAC
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Gender | Female
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 102 W MAIN ST
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City | NORTH MANCHESTER
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State | IN
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Zip | 46962-1502
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Country | US
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Telephone | 260-901-6699
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Fax |
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Provider Business Mailing Address
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Address Line | 702 N MILL ST
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City | NORTH MANCHESTER
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State | IN
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Zip | 46962-1240
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Country | US
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Telephone | 765-243-5512
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 84000240A
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License Number State | IN
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