Provider Demographics
NPI:1679692024
Name:LAVINE, JOSEPH A (CMT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:LAVINE
Suffix:
Gender:M
Credentials:CMT
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 353
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-0353
Mailing Address - Country:US
Mailing Address - Phone:717-514-8699
Mailing Address - Fax:
Practice Address - Street 1:44 W MARKET ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:PA
Practice Address - Zip Code:17547-1424
Practice Address - Country:US
Practice Address - Phone:717-426-3166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist