Provider Demographics
NPI:1528584984
Name:MARCOULLIER, LAUREN (DC, ND)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MARCOULLIER
Suffix:
Gender:F
Credentials:DC, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1510
Mailing Address - Country:US
Mailing Address - Phone:207-641-7911
Mailing Address - Fax:
Practice Address - Street 1:78 CONCORD ST
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1513
Practice Address - Country:US
Practice Address - Phone:603-924-3777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR2445111N00000X
NH0013175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractor