Provider Demographics
NPI:1053446138
Name:VARGA, LAURA JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JEAN
Last Name:VARGA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:JEAN
Other - Last Name:MCLAUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:35000 DIVISION RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-1566
Mailing Address - Country:US
Mailing Address - Phone:586-727-8900
Mailing Address - Fax:586-727-3300
Practice Address - Street 1:35000 DIVISION RD
Practice Address - Street 2:SUITE 7
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-1566
Practice Address - Country:US
Practice Address - Phone:586-727-8900
Practice Address - Fax:586-727-3300
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP46110001Medicare PIN