Provider Demographics
NPI:1720248404
Name:VANRENEN, LOUIS J (LIC AC)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:J
Last Name:VANRENEN
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AMERICAN ACUPUNCTURE
Mailing Address - Street 2:171 ROCKLAND STREET
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339
Mailing Address - Country:US
Mailing Address - Phone:781-826-7606
Mailing Address - Fax:
Practice Address - Street 1:AMERICAN ACUPUNCTURE
Practice Address - Street 2:171 ROCKLAND STREET
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339
Practice Address - Country:US
Practice Address - Phone:781-826-7606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA57171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist