Provider Demographics
NPI:1659723237
Name:KOZMINSKI-VANDERHART, LAURA (DVM)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:KOZMINSKI-VANDERHART
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5978
Mailing Address - Country:US
Mailing Address - Phone:216-831-6789
Mailing Address - Fax:216-831-4653
Practice Address - Street 1:4760 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5978
Practice Address - Country:US
Practice Address - Phone:216-831-6789
Practice Address - Fax:216-831-4653
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHVET.10514174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist