Provider Demographics
NPI:1922185701
Name:PIRKL, LAURA MARIE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:PIRKL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 COMMERCE DR NW
Mailing Address - Street 2:300
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-3144
Mailing Address - Country:US
Mailing Address - Phone:507-206-4660
Mailing Address - Fax:507-206-4783
Practice Address - Street 1:2711 COMMERCE DR NW
Practice Address - Street 2:300
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-3144
Practice Address - Country:US
Practice Address - Phone:507-206-4660
Practice Address - Fax:507-206-4783
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN330415900Medicaid
MN330415900Medicaid
MN350002882Medicare PIN