Provider Demographics
NPI:1083915359
Name:CROTEAU, LACHLAN PETER (LMT)
Entity Type:Individual
Prefix:MR
First Name:LACHLAN
Middle Name:PETER
Last Name:CROTEAU
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HIGHLAND CIR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3099
Mailing Address - Country:US
Mailing Address - Phone:781-454-9387
Mailing Address - Fax:
Practice Address - Street 1:35 HIGHLAND CIR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3099
Practice Address - Country:US
Practice Address - Phone:781-454-9387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1508225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist