Individual
DR. LAURETTA LYNNE CLOWES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
78 BROAD AVE, SUSQUEHANNA, PA 18847-2621
(570) 853-3332
(570) 853-3516
Mailing address
78 BROAD AVE, SUSQUEHANNA, PA 18847-2621
(570) 853-3332
(570) 853-3516
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC003000L
PA
111N00000X
Chiropractor
X4336
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013015190001
—
PA
01
—
00456611
BLUECROSS/BLUESHIELD
PA
01
—
820362
FIRST PRIORITY HEALTH
—
Enumeration date
07/27/2006
Last updated
07/01/2008
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