Provider Demographics
NPI:1346577699
Name:DUNCAN, LAURA C (OT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:C
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:C
Other - Last Name:GRAFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 19TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-3700
Mailing Address - Country:US
Mailing Address - Phone:309-779-7600
Mailing Address - Fax:309-779-7429
Practice Address - Street 1:106 19TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-3700
Practice Address - Country:US
Practice Address - Phone:309-779-7600
Practice Address - Fax:309-779-7429
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056001754225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist