Provider Demographics
NPI:1003584863
Name:ALSOBROOKS, JOHN M (MB, LAC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:ALSOBROOKS
Suffix:
Gender:M
Credentials:MB, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7030
Mailing Address - Country:US
Mailing Address - Phone:207-531-5346
Mailing Address - Fax:207-241-7600
Practice Address - Street 1:369 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7030
Practice Address - Country:US
Practice Address - Phone:207-531-5346
Practice Address - Fax:207-241-7600
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-05
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC02076171100000X
MEAC693171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty