Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT37628 | FL |
NPI | 1033885918 |
---|---|
Provider Name | Brian Richard Laskowski |
First Address | Temple Terrace, FL 33637-0915 |
Second Address | Temple Terrace, FL 33637-0915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2021 |
Last Update Date | 19/08/2021 |