Healthcare Provider Details

I. General information

NPI: 1699546226
Provider Name (Legal Business Name): LAURA MCCOY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 US HIGHWAY 50
HILLSBORO OH
45133-9158
US

IV. Provider business mailing address

1856 CEDAR HILL RD
LANCASTER OH
43130-4178
US

V. Phone/Fax

Practice location:
  • Phone: 937-579-5027
  • Fax:
Mailing address:
  • Phone: 740-796-8835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: