Provider Demographics
NPI:1043362346
Name:LASKO CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:LASKO CHIROPRACTIC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LASKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:831-373-7373
Mailing Address - Street 1:2560 GARDEN RD.
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-373-7373
Mailing Address - Fax:831-373-7305
Practice Address - Street 1:2560 GARDEN RD.
Practice Address - Street 2:SUITE 212
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-373-7373
Practice Address - Fax:831-373-7305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty