Provider Demographics
NPI:1467030460
Name:LASSITER, SYDNEY STROUD (DC)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:STROUD
Last Name:LASSITER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SYDNEY
Other - Middle Name:BLAIR
Other - Last Name:STROUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3204 ARCHDALE RD
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-2710
Mailing Address - Country:US
Mailing Address - Phone:336-434-2107
Mailing Address - Fax:336-434-2109
Practice Address - Street 1:3204 ARCHDALE RD
Practice Address - Street 2:
Practice Address - City:ARCHDALE
Practice Address - State:NC
Practice Address - Zip Code:27263-2710
Practice Address - Country:US
Practice Address - Phone:336-434-2107
Practice Address - Fax:336-434-2109
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor