Provider Demographics
NPI:1760727267
Name:POPELKA, LAURA ANN (BCHIS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:POPELKA
Suffix:
Gender:F
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 ENTERPRISE RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-3326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:921 BLAIRS FERRY RD NE STE 110
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-1262
Practice Address - Country:US
Practice Address - Phone:319-378-8077
Practice Address - Fax:319-378-8078
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA976237700000X
IA000976237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist