Provider Demographics
NPI:1770879348
Name:AGNEW, LAURA CALCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CALCOTT
Last Name:AGNEW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:15520 ROCKFIELD BLVD
Mailing Address - Street 2:STE A200
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-6705
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:1200 VICENTE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-3044
Practice Address - Country:US
Practice Address - Phone:415-702-6755
Practice Address - Fax:415-520-0259
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2019-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA31951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor