Provider Demographics
NPI:1073217790
Name:LECLAIR, ASHLEY (LAC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:LECLAIR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:683 GOOSE NECK DR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8368
Mailing Address - Country:US
Mailing Address - Phone:412-719-7977
Mailing Address - Fax:773-496-8835
Practice Address - Street 1:6 S BROAD ST
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-1402
Practice Address - Country:US
Practice Address - Phone:717-454-6762
Practice Address - Fax:773-496-8835
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAAK001406171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist