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General NPI Number Information
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NPI Number | 1972730091
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Entity Type | Individual
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Provider Name | LAURA ANN BEQUETTE O.D., OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 223 MAIN ST
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City | FESTUS
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State | MO
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Zip | 63028-1952
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Country | US
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Telephone | 636-937-2399
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Fax | 366-937-4683
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Provider Business Mailing Address
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Address Line | 223 MAIN ST
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City | FESTUS
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State | MO
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Zip | 63028-1952
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Country | US
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Telephone | 636-937-2399
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Fax | 366-937-4683
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2001015114
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2009032890
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License Number State | MO
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