Provider Demographics
NPI:1871768747
Name:LOTERSZPIL, LAURA (LIC AC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LOTERSZPIL
Suffix:
Gender:F
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 1:12506 KENSINGTON LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2736
Mailing Address - Country:US
Mailing Address - Phone:301-325-0828
Mailing Address - Fax:
Practice Address - Street 1:12506 KENSINGTON LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-2736
Practice Address - Country:US
Practice Address - Phone:301-325-0828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01154171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist