Provider Demographics
NPI:1457383598
Name:VERGA, LAURA ANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANNE
Last Name:VERGA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:ANNE
Other - Last Name:VASSAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1830 WEBSTER ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-9320
Mailing Address - Country:US
Mailing Address - Phone:715-381-9680
Mailing Address - Fax:
Practice Address - Street 1:1830 WEBSTER ST
Practice Address - Street 2:SUITE 130
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-9320
Practice Address - Country:US
Practice Address - Phone:715-381-9680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4336-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor