Provider Demographics
NPI:1760791172
Name:ZAGROCKI, LAURA (DPM)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:ZAGROCKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 S PERRY ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1901
Mailing Address - Country:US
Mailing Address - Phone:303-814-1082
Mailing Address - Fax:
Practice Address - Street 1:755 S PERRY ST
Practice Address - Street 2:SUITE 500
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1901
Practice Address - Country:US
Practice Address - Phone:303-814-1082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-03
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00364213ES0103X
CO0000731213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery