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Organization
MOODY STREET TOTAL HEALTH, INC.
Active
Organization
MOODY STREET TOTAL HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN LYNN ST.LAURENT (OWNER)
(978) 821-7054
Entity
Organization
Contact information
Practice address
3 COMMON STREET #2, WALTHAM, MA 02451
(978) 821-7054
(774) 208-0712
Mailing address
3 COMMON STREET #2, WALTHAM, MA 02451
(978) 821-7054
(774) 208-0712
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2269
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033487192
HCVM
MA
05
—
1612913
—
MA
01
—
1867401004
CIGNA HEALTH CARE
MA
01
—
27243
NEIGHBORHOOD HEALTH PLAN
MA
01
—
2859278
AETNA/US HEALTHCARE
MA
01
—
351902
HARVARD PILGRIM
MA
01
—
4404288
UNITED HEALTH CARE
MA
01
—
798431
TUFTS HEALTH PLAN
MA
01
—
9228734
PHCS
MA
01
—
974044
NETWORK HEALTH PLAN
MA
01
—
Y36596
BC/BS OF MA INDIVIDUAL ID
MA
01
—
Y39835
BC/BS OF MA GROUP ID
MA
Enumeration date
12/23/2005
Last updated
07/21/2021
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