Provider Demographics
NPI:1073863619
Name:GREGOR-HODNE, LAURA JUDE (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JUDE
Last Name:GREGOR-HODNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 AMHERST RD
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-2734
Mailing Address - Country:US
Mailing Address - Phone:770-500-0423
Mailing Address - Fax:
Practice Address - Street 1:189 MAIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2627
Practice Address - Country:US
Practice Address - Phone:508-482-0642
Practice Address - Fax:508-482-0697
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA003167501Medicare UPIN