Provider Demographics
NPI:1336324516
Name:TOTH, SUSAN L (LAC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:TOTH
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 1:25 HAM ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3152
Mailing Address - Country:US
Mailing Address - Phone:603-969-1430
Mailing Address - Fax:
Practice Address - Street 1:1 CATE ST
Practice Address - Street 2:UNIT 1
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7108
Practice Address - Country:US
Practice Address - Phone:603-969-1430
Practice Address - Fax:603-422-8849
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH107171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist