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General NPI Number Information
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NPI Number | 1558950139
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Entity Type | Individual
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Provider Name | TREVOR RICHARD LAUFFER DC
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Gender | Male
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Dates
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Enumeration Date | 01/18/2021
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 1343 S INTERNATIONAL PKWY
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City | LAKE MARY
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State | FL
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Zip | 32746-1401
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Country | US
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Telephone | 407-792-0705
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Fax | 407-792-0710
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Provider Business Mailing Address
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Address Line | 732 KENILWORTH CIR APT 204
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City | HEATHROW
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State | FL
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Zip | 32746-5571
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Country | US
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Telephone | 717-379-3672
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH13383
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License Number State | FL
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