Provider Demographics
NPI:1841434222
Name:LAURA ZELENAK, D.O., P.C.
Entity type:Organization
Organization Name:LAURA ZELENAK, D.O., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ERMAN
Authorized Official - Last Name:ZELENAK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-724-0591
Mailing Address - Street 1:6672 NEWARK RD
Mailing Address - Street 2:
Mailing Address - City:IMLAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48444-9657
Mailing Address - Country:US
Mailing Address - Phone:810-724-0591
Mailing Address - Fax:810-724-0272
Practice Address - Street 1:6672 NEWARK RD
Practice Address - Street 2:
Practice Address - City:IMLAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48444-9657
Practice Address - Country:US
Practice Address - Phone:810-724-0591
Practice Address - Fax:810-724-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101014679207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty