Individual
DR. LAURA LEANNE DETERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1101 N MAIN ST, MARION, WI 54950-9182
(715) 754-2555
(715) 754-2556
Mailing address
PO BOX 485, MARION, WI 54950-0485
(715) 754-2555
(715) 754-2556
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2895-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38866500
—
WI
05
—
38984900
—
WI
Enumeration date
12/05/2006
Last updated
07/09/2007
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