Provider Demographics
NPI:1760697502
Name:LAUR, DAGNY (CO)
Entity Type:Individual
Prefix:MISS
First Name:DAGNY
Middle Name:
Last Name:LAUR
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:DAGNY
Other - Middle Name:FRISCHMANN
Other - Last Name:LAUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CO
Mailing Address - Street 1:117 SAGAMORE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LAPORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 EAST MORTHLAND DRIVE (US RT 30)
Practice Address - Street 2:SUITE 2
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46350
Practice Address - Country:US
Practice Address - Phone:219-531-7479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist