Provider Demographics
NPI:1982949111
Name:LASKOW CHIROPRACTIC CLINIC PA
Entity type:Organization
Organization Name:LASKOW CHIROPRACTIC CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LASKOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-464-3030
Mailing Address - Street 1:822 LAKE ST S
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-2614
Mailing Address - Country:US
Mailing Address - Phone:651-464-3030
Mailing Address - Fax:651-982-6034
Practice Address - Street 1:822 LAKE ST S
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2614
Practice Address - Country:US
Practice Address - Phone:651-464-3030
Practice Address - Fax:651-982-6034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty