Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS008714L | PA |
N | 207Q00000X | Family Doctor | OS008714L | PA |
NPI | 1578741567 |
---|---|
Provider Name | Dr. Christopher Thomas Laseter |
First Address | Lancaster, PA 17603-4349 |
Second Address | Lancaster, PA 17603-4349 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2008 |
Last Update Date | 01/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01626917 | (05) | PA |
F41699 | (02) |