Provider Demographics
NPI:1265863781
Name:CATUREGLI, MARCO (LAC)
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:
Last Name:CATUREGLI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83048 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CRESWELL
Mailing Address - State:OR
Mailing Address - Zip Code:97426-9711
Mailing Address - Country:US
Mailing Address - Phone:541-214-8902
Mailing Address - Fax:
Practice Address - Street 1:104 S MILL ST STE 101
Practice Address - Street 2:
Practice Address - City:CRESWELL
Practice Address - State:OR
Practice Address - Zip Code:97426-9130
Practice Address - Country:US
Practice Address - Phone:541-214-8902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC163374171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist