Provider Demographics
NPI:1528825858
Name:VOSBURGH, LAURYN IOANNA
Entity type:Individual
Prefix:
First Name:LAURYN
Middle Name:IOANNA
Last Name:VOSBURGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LAKE ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:MA
Mailing Address - Zip Code:01562-1831
Mailing Address - Country:US
Mailing Address - Phone:480-809-7411
Mailing Address - Fax:
Practice Address - Street 1:39 LAKE ST UNIT 1
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:MA
Practice Address - Zip Code:01562-1831
Practice Address - Country:US
Practice Address - Phone:480-809-7411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist