Provider Demographics
NPI:1962099648
Name:LASKEY PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:LASKEY PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LASKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:207-650-7068
Mailing Address - Street 1:405 LEWIS HILL RD
Mailing Address - Street 2:
Mailing Address - City:BOWDOIN
Mailing Address - State:ME
Mailing Address - Zip Code:04287-7324
Mailing Address - Country:US
Mailing Address - Phone:207-650-7068
Mailing Address - Fax:
Practice Address - Street 1:44 ELM ST
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1418
Practice Address - Country:US
Practice Address - Phone:207-650-7068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty