Provider Demographics
NPI:1548360340
Name:BUCHHEIT, LAURA
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:BUCHHEIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N. MAIN
Mailing Address - Street 2:P.O. BOX 331
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-0331
Mailing Address - Country:US
Mailing Address - Phone:573-517-0696
Mailing Address - Fax:573-517-0844
Practice Address - Street 1:707 N. MAIN
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-0331
Practice Address - Country:US
Practice Address - Phone:573-517-0696
Practice Address - Fax:573-517-0844
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO405435OtherHEALTHLINK
MO119460OtherBCBS
U51281Medicare UPIN