Provider Demographics
NPI:1881740207
Name:ZELASKO, LAURA ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANNE
Last Name:ZELASKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 PORTAGE TRL
Mailing Address - Street 2:SUITE #3
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2122
Mailing Address - Country:US
Mailing Address - Phone:330-926-9920
Mailing Address - Fax:330-926-9940
Practice Address - Street 1:1604 PORTAGE TRL
Practice Address - Street 2:SUITE #3
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2122
Practice Address - Country:US
Practice Address - Phone:330-926-9920
Practice Address - Fax:330-926-9940
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0987562Medicaid
OH34184213500OtherWORKERS COMPENSATION NUMB
OHZE4062371Medicare ID - Type Unspecified
OH0987562Medicaid