Wanner, Laurent Edward

Wanner, Laurent Edward is an individual health care provider with primary practice located at 1000 Northcrest Dr Ste 3 , Crescent City CA 95531-2317. He recently has only one registered license in Chiropractic Providers / Occupational Health, which is considered as his primary health care specialty. Wanner, Laurent Edward can be contacted via phone (707) 465-4132.

Contact Information

Primary practice address
1000 Northcrest Dr Ste 3 Crescent City CA 95531-2317
Phone: (707) 465-4132
Fax: (707) 465-4132
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Occupational Health 111NX0100X DC0020025 California

Profile Details

NPI number 1093892697
LBN Legal business name Wanner, Laurent Edward
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Sep 16th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093892697 NPPES
California MEDICAID DC0200250

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