Individual
LAURA J ALTAVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
123 WHITNEY STREET, GARDNER, MA 01440
(978) 632-5885
(978) 630-3774
Mailing address
123 WHITNEY STREET, GARDNER, MA 01440
(978) 632-5885
(978) 630-3774
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1336
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043116527
TAX ID
—
01
—
15021
FALLON
—
01
—
1609149
MASSHEALTH
—
05
—
1609149
—
MA
01
—
203139600
ACS DEPT OF LABOR
—
01
—
2045784
FIRST HEALTH CNN HCVM
—
01
—
210035
ACN ASHN
—
01
—
30700
CIGNA
—
01
—
350053673
RR MEDICARE PALMETTO
—
01
—
351050
HARVARD PILGRIM
—
01
—
4481980
AETNA
—
01
—
80705
ONE HEALTH GREAT WEST
—
01
—
898687
FOCUS BEECH STREET
—
01
—
986271
NETWORK HEALTH
—
01
—
OO13407
NEIGHBORHOOD
—
01
—
RRCAT810191834
PRIVATE HEALTHCARE SYSTEM
—
01
—
Y35953
MEDICARE
—
Enumeration date
07/28/2006
Last updated
08/05/2020
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