Provider Demographics
NPI:1053503367
Name:TRAVIS, JANET E (LAC)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:E
Last Name:TRAVIS
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 1:31 SUGAR PLUM LN
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3300
Mailing Address - Country:US
Mailing Address - Phone:603-490-8260
Mailing Address - Fax:603-434-5339
Practice Address - Street 1:13 ORCHARD VIEW DR
Practice Address - Street 2:ACUPUNCTURE SERVICES OF NEW ENGLAND, SUITE 7, BOX 6
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3457
Practice Address - Country:US
Practice Address - Phone:603-490-8260
Practice Address - Fax:603-434-5339
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2012-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH077171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist