Provider Demographics
NPI:1851584775
Name:MCCONNELL, LIZA K (D AC)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:K
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:D AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 COUNTY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4586
Mailing Address - Country:US
Mailing Address - Phone:401-447-5545
Mailing Address - Fax:
Practice Address - Street 1:147 COUNTY RD STE 300
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-4586
Practice Address - Country:US
Practice Address - Phone:401-447-5545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDA00302171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist