LAURENT WANNER CHIROPRACTIC, INC. (NPI# 1720387228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720387228 |
| Entity Type | Organization |
| Organization Name | LAURENT WANNER CHIROPRACTIC, INC. |
| Other Organization Name | WANNER SPORTS & FAMILY CHIROPRACTIC |
| Practice Address |
1000 Northcrest Dr Ste 3 Crescent City CA 95531-2317 |
| Practice Telephone | 7074654132 |
| Practice Fax Number | 7074654132 |
| Mailing Telephone | 7074654132 |
| Mailing Fax Number | 7074654132 |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2011-04-08 |
| Authorized Official Name | DR. LAURENT E WANNER (DOCTOR OF CHIROPRACTIC) |
| Authorized Official Telephone | 7074654132 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
200250 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DC0200250 | 05 |
| Other Name | Type Code |
|---|---|
| Wanner Sports & Family Chiropractic | Doing Business As Name - Organization |
| Street Address |
1000 NORTHCREST DR STE 3 |
| City | CRESCENT CITY |
| State | CA |
| Zip Code | 95531-2317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093892697 | Laurent Edward Wanner | Chiropractor | 1000 Northcrest Dr Ste 3, Crescent City, CA 95531-2317 | 2006-11-01 |
| 1639620685 | Laurent E Wanner Chiropractic Inc | Chiropractor | 1000 Northcrest Dr Ste 3, Crescent City, CA 95531-2317 | 2016-10-14 |
| 1457759920 | Wanner Chiropractic | Preferred Provider Organization | 1000 Northcrest Dr Ste 3, Crescent City, CA 95531-2317 | 2014-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548725237 | John Michael Horner | Counselor | 455 Kst, Crescent City, CA 95531 | 2019-02-06 |
| 1245716943 | Tonya Shantel Escobar | Registered Nurse | 1301b Northcrest Drive #13, Crescent City, CA 95531 | 2018-07-16 |
| 1679019319 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 657 Hwy 101 N, Crescent City, CA 95531 | 2017-01-18 |
| 1063969558 | Darrick Stewart Roach | Massage Therapist | 1225 Marshall St., 18, Crescent City, CA 95531 | 2016-09-01 |
| 1447638044 | Yelena Zaitseva Lavender | Counselor | 455 K Street, Crescent City, CA 95531 | 2015-05-14 |
| 1942630421 | Kamilia Ann Schnacker | Counselor | 370 9th Street, Crescent City, CA 95531 | 2013-11-19 |
| 1881906261 | Peter Allen Brown | Psychologist | 505 H Street, Crescent City, CA 95531 | 2010-07-13 |
| 1700119385 | Remi Vista Services for Probation Youth | Community/Behavioral Health | 206 Williams Dr # 2, Crescent City, CA 95531 | 2009-09-14 |
| 1982862538 | Joshua Thomas Matson | Chiropractor | 550 E Washington Blvd Ste 100, Crescent City, CA 95531 | 2008-05-30 |
| 1902076250 | County of Del Norte | Community/Behavioral Health | 1125 Burtschell, Crescent City, CA 95531 | 2008-03-03 |
| Find all providers in zip 95531 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| Find all providers with the same taxonomy | ||||
| City | CRESCENT CITY |
| Zip Code | 95531 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.