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General NPI Number Information
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NPI Number | 1538384730
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Entity Type | Individual
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Provider Name | KATHERINE ZAGROBA O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 950 N MAIN ST
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City | LACONIA
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State | NH
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Zip | 03246-2628
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Country | US
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Telephone | 603-524-5770
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Fax | 603-524-2424
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Provider Business Mailing Address
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Address Line | 950 N MAIN ST
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City | LACONIA
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State | NH
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Zip | 03246-2628
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Country | US
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Telephone | 603-524-5770
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Fax | 603-524-2424
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 430
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 430
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License Number State | NH
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