Provider Demographics
NPI:1548586001
Name:PILLARELLA, LAURA (LMT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:PILLARELLA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SHARON CIR
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-1470
Mailing Address - Country:US
Mailing Address - Phone:508-265-1966
Mailing Address - Fax:
Practice Address - Street 1:112 MAIN ST
Practice Address - Street 2:
Practice Address - City:UPTON
Practice Address - State:MA
Practice Address - Zip Code:01568-1613
Practice Address - Country:US
Practice Address - Phone:508-265-1966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA# MT-00019-MT172M00000X
MA#MT-00239-MT172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist