MEDICARE: LAUREN C LEROY D.C.

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	12190	TX

General Provider Information

NPI Number	:	1609115666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN C LEROY D.C.

Provider Business Mailing Address
First Line	:	27646 COMMERCE OAKS DR
Second Line	:
City	:	OAK RIDGE NORTH
State	:	TX
Zip	:	77385-4404
Country	:	US
Telephone Number	:	920-279-7701
Fax Number	:

Provider Business Practice Location Address
First Line	:	27646 COMMERCE OAKS DR
Second Line	:
City	:	OAK RIDGE NORTH
State	:	TX
Zip	:	77385-4404
Country	:	US
Telephone Number	:	920-279-7701
Fax Number	:

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

Provider Enumeration Date	:	02/11/2013
Last Update Date	:	02/11/2013

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Directions to “ LAUREN C LEROY D.C.” Practice Location

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