Provider Demographics
NPI:1902857394
Name:GODFREY, LAURA VIRGINIA (DC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:VIRGINIA
Last Name:GODFREY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:239 BOSTON ST
Mailing Address - Street 2:SUITE 212/214
Mailing Address - City:TOPSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01983-2215
Mailing Address - Country:US
Mailing Address - Phone:978-887-9889
Mailing Address - Fax:978-360-6023
Practice Address - Street 1:239 BOSTON ST
Practice Address - Street 2:SUITE 212/214
Practice Address - City:TOPSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01983-2215
Practice Address - Country:US
Practice Address - Phone:978-887-9889
Practice Address - Fax:978-360-6023
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA043513290OtherHEALTH CARE VALUE MANAGEM
MA57972OtherCIGNA HEALTH CARE
MA457523OtherTUFTS
MA7949174OtherAETNA US HEALTHCARE
MA043513290OtherUNICARE
MAY39382OtherBLUE CROSS & BLUE SHIELD
MA043513290OtherUNICARE