Provider Demographics
NPI:1104128370
Name:WINTERS, ALISON B (LAC)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:B
Last Name:WINTERS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LOW ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-4046
Mailing Address - Country:US
Mailing Address - Phone:415-573-6093
Mailing Address - Fax:
Practice Address - Street 1:20 LOW ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-4046
Practice Address - Country:US
Practice Address - Phone:415-573-6093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12893171100000X
NHACP 179171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist