MEDICARE: DR. CHRISTOPHER VINCENT LAURES D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	T-01679	KS
2	111N00000X	Chiropractor	007040	IA

General Provider Information

NPI Number	:	1629250972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER VINCENT LAURES D.C.

Provider Business Mailing Address
First Line	:	711 SIOUX POINT ROAD
Second Line	:	SUITE 300
City	:	DAKOTA DUNES
State	:	SD
Zip	:	57049-0000
Country	:	US
Telephone Number	:	605-232-1711
Fax Number	:	605-232-2040

Provider Business Practice Location Address
First Line	:	3403 SINGING HILLS BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106-5109
Country	:	US
Telephone Number	:	712-255-9909
Fax Number	:	712-252-4730

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	07/31/2008

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