Individual
MR. LAURENT EDWARD WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1000 NORTHCREST DR STE 3, CRESCENT CITY, CA 95531-2317
(707) 465-4132
(707) 465-4132
Mailing address
1000 NORTHCREST DR STE 3, CRESCENT CITY, CA 95531-2317
(707) 465-4132
(707) 465-4132
Taxonomy
Speciality
Code
Description
License number
State
111NX0100X
Occupational Health Chiropractor
Primary
DC0020025
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DC0200250
—
CA
Enumeration date
11/01/2006
Last updated
09/16/2016
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