Provider Demographics
NPI:1619032364
Name:PAPPAS, TED ALEN (LAC)
Entity Type:Individual
Prefix:MR
First Name:TED
Middle Name:ALEN
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6 APOLLO CIR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-2414
Mailing Address - Country:US
Mailing Address - Phone:978-975-7541
Mailing Address - Fax:978-975-7541
Practice Address - Street 1:6 APOLLO CIR
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-2414
Practice Address - Country:US
Practice Address - Phone:978-975-7541
Practice Address - Fax:978-975-7541
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA294171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist