MEDICARE: DR. LAURA JEAN VARGA DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301009319	MI

General Provider Information

NPI Number	:	1053446138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA JEAN VARGA DC

Provider Business Mailing Address
First Line	:	35000 DIVISION RD
Second Line	:	SUITE 7
City	:	RICHMOND
State	:	MI
Zip	:	48062-1566
Country	:	US
Telephone Number	:	586-727-8900
Fax Number	:	586-727-3300

Provider Business Practice Location Address
First Line	:	35000 DIVISION RD
Second Line	:	SUITE 7
City	:	RICHMOND
State	:	MI
Zip	:	48062-1566
Country	:	US
Telephone Number	:	586-727-8900
Fax Number	:	586-727-3300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	11/07/2007

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