Provider Demographics
NPI:1639218126
Name:MOERTH, ESTHER BARBARA (DOM,LAC,DIPLCH)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:BARBARA
Last Name:MOERTH
Suffix:
Gender:F
Credentials:DOM,LAC,DIPLCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 901
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:MA
Mailing Address - Zip Code:01379-0901
Mailing Address - Country:US
Mailing Address - Phone:413-313-7290
Mailing Address - Fax:
Practice Address - Street 1:974 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-5114
Practice Address - Country:US
Practice Address - Phone:413-313-7290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM731171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM201044209OtherPRESBYTHERIAN PROVIDER ID
NM900179757OtherTAX ID
NMNM024G04OtherBLUE CROSS BLUE SHIELD ID