Provider Demographics
NPI:1033188941
Name:LASCOTTE, CAROL (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:LASCOTTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2552 HIGHWAY 10 NE
Mailing Address - Street 2:
Mailing Address - City:MOUNDS VIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55112-4032
Mailing Address - Country:US
Mailing Address - Phone:763-786-5581
Mailing Address - Fax:763-786-6016
Practice Address - Street 1:2552 HIGHWAY 10 NE
Practice Address - Street 2:
Practice Address - City:MOUNDS VIEW
Practice Address - State:MN
Practice Address - Zip Code:55112-4032
Practice Address - Country:US
Practice Address - Phone:763-786-5581
Practice Address - Fax:763-786-6016
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN330328400Medicaid
MN330328400Medicaid
MN350000328Medicare ID - Type Unspecified