Provider Demographics
NPI:1093475014
Name:LASKARIS, HEATHER ELOIS (PT, DPT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELOIS
Last Name:LASKARIS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41125 N DAISY MOUNTAIN DR STE 121
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-4964
Mailing Address - Country:US
Mailing Address - Phone:480-265-2132
Mailing Address - Fax:623-551-5078
Practice Address - Street 1:14001 N 7TH ST STE F112
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4382
Practice Address - Country:US
Practice Address - Phone:480-359-3141
Practice Address - Fax:480-265-2141
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist