Provider Demographics
NPI:1992075766
Name:PARIS, LAURA M (ABOC, NCLEC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:M
Last Name:PARIS
Suffix:
Gender:F
Credentials:ABOC, NCLEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 COOPER FOSTER PARK RD STE 103
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-1206
Mailing Address - Country:US
Mailing Address - Phone:440-654-4986
Mailing Address - Fax:440-654-4987
Practice Address - Street 1:1895 COOPER FOSTER PARK RD STE 103
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1206
Practice Address - Country:US
Practice Address - Phone:440-654-4986
Practice Address - Fax:440-654-4987
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH060347156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist