Provider Demographics
NPI:1699918045
Name:VESCO, LAURA (ND)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:VESCO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2012
Mailing Address - Country:US
Mailing Address - Phone:406-565-5985
Mailing Address - Fax:
Practice Address - Street 1:124 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2012
Practice Address - Country:US
Practice Address - Phone:406-565-5985
Practice Address - Fax:406-723-5985
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT118175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath