MEDICARE: DR. LAURA ZAGROCKI DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	00364	KY
2	213ES0103X	Foot & Ankle Surgery Podiatrist	0000731	CO

General Provider Information

NPI Number	:	1760791172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA ZAGROCKI DPM

Provider Business Mailing Address
First Line	:	755 S PERRY ST
Second Line	:	SUITE 500
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-1901
Country	:	US
Telephone Number	:	303-814-1082
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 S PERRY ST
Second Line	:	SUITE 500
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-1901
Country	:	US
Telephone Number	:	303-814-1082
Fax Number	:

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

Provider Enumeration Date	:	10/03/2010
Last Update Date	:	03/27/2014

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