Provider Demographics
NPI:1881096659
Name:LAUB, STEPHAN (DC)
Entity type:Individual
Prefix:
First Name:STEPHAN
Middle Name:
Last Name:LAUB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-0051
Mailing Address - Country:US
Mailing Address - Phone:859-586-9777
Mailing Address - Fax:859-689-6133
Practice Address - Street 1:2950 HEBRON PARK DR STE E
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-8511
Practice Address - Country:US
Practice Address - Phone:859-586-9777
Practice Address - Fax:859-689-6133
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5446111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor