Provider Demographics
NPI:1629217245
Name:GREENE-ORNDORFF, LAURA RENE (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:RENE
Last Name:GREENE-ORNDORFF
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 1:105 WOODRANCH LN
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:SC
Mailing Address - Zip Code:29369-8909
Mailing Address - Country:US
Mailing Address - Phone:864-576-1987
Mailing Address - Fax:
Practice Address - Street 1:105 WOODRANCH LN
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:SC
Practice Address - Zip Code:29369-8909
Practice Address - Country:US
Practice Address - Phone:864-576-1987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2074111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor