Provider Demographics
NPI:1720731391
Name:KOLANSKY, LAUREN (DACM, MAOM,)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KOLANSKY
Suffix:
Gender:F
Credentials:DACM, MAOM,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-4502
Mailing Address - Country:US
Mailing Address - Phone:828-649-5016
Mailing Address - Fax:828-201-2335
Practice Address - Street 1:3 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-4502
Practice Address - Country:US
Practice Address - Phone:828-649-5016
Practice Address - Fax:828-201-2335
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2099171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist