Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 31307 | MN |
N | 2081S0010X | Sports Medicine | 31307 | MN |
N | 213ES0000X | Sports Medicine | 31307 | MN |
NPI | 1003894312 |
---|---|
Provider Name | Edward R Laskowski |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 18/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E39396 | (02) |