Provider Demographics
NPI:1538384730
Name:ZAGROBA, KATHERINE (OD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ZAGROBA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2628
Mailing Address - Country:US
Mailing Address - Phone:603-524-5770
Mailing Address - Fax:603-524-2424
Practice Address - Street 1:950 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2628
Practice Address - Country:US
Practice Address - Phone:603-524-5770
Practice Address - Fax:603-524-2424
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH430152W00000X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152W00000XEye and Vision Services ProvidersOptometrist