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General NPI Number Information
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NPI Number | 1265620751
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Entity Type | Organization
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Legal Business Name | NICOLE M. LAUER CHIROPRACTIC P.A.
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 2600 S MERIDIAN APT 1412
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City | PUYALLUP
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State | WA
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Zip | 98373-1556
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Country | US
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Telephone | 763-772-8723
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Fax | 253-473-2484
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Provider Business Mailing Address
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Address Line | 2600 S MERIDIAN APT 1412
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City | PUYALLUP
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State | WA
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Zip | 98373-1556
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Country | US
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Telephone | 763-772-8723
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Fax | 253-473-2484
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. NICOLE MARIE LAUER
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Credential | D.C.
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Telephone | 763-772-8723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4978
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH60023270
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License Number State | WA
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