Provider Demographics
NPI:1073513339
Name:LAUSCH, MICHELE RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:RENEE
Last Name:LAUSCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-9795
Mailing Address - Country:US
Mailing Address - Phone:717-733-6866
Mailing Address - Fax:
Practice Address - Street 1:11 LONG AVE
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-9795
Practice Address - Country:US
Practice Address - Phone:717-733-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005668L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA618593Medicare ID - Type Unspecified