Provider Demographics
NPI:1356415608
Name:HARDIGG, LORLI LOOMIS (MAC)
Entity type:Individual
Prefix:MS
First Name:LORLI
Middle Name:LOOMIS
Last Name:HARDIGG
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:MS
Other - First Name:ELINOR
Other - Middle Name:LOOMIS
Other - Last Name:HARDIGG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAC
Mailing Address - Street 1:61 BEAVER POND RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3308
Mailing Address - Country:US
Mailing Address - Phone:781-259-0639
Mailing Address - Fax:
Practice Address - Street 1:61 BEAVER POND RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-3308
Practice Address - Country:US
Practice Address - Phone:781-259-0639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA595171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist