Provider Demographics
NPI:1902404908
Name:LAUER, CHRISTINE L (RDN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:L
Last Name:LAUER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CORAL DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-8514
Mailing Address - Country:US
Mailing Address - Phone:616-485-7507
Mailing Address - Fax:
Practice Address - Street 1:24 CORAL DR NE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-8514
Practice Address - Country:US
Practice Address - Phone:616-485-7507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered