Provider Demographics
NPI:1669562682
Name:HANSMANN, LAURA GLASSER (RPH)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:GLASSER
Last Name:HANSMANN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6979 W OTSEGO LAKE DR
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-8624
Mailing Address - Country:US
Mailing Address - Phone:989-732-6060
Mailing Address - Fax:989-732-6577
Practice Address - Street 1:806 S OTSEGO AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1725
Practice Address - Country:US
Practice Address - Phone:989-732-6555
Practice Address - Fax:989-732-6577
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020239761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy