Provider Demographics
NPI:1003254517
Name:FLOWERS, LAURA (LAC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16381 HIGHLAND MESA DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3508
Mailing Address - Country:US
Mailing Address - Phone:619-252-0045
Mailing Address - Fax:
Practice Address - Street 1:15708 POMERADO RD STE N-203
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2066
Practice Address - Country:US
Practice Address - Phone:619-252-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17697171100000X
NY25 004081171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty