Provider Demographics
NPI:1073099321
Name:LAZARO, EDMER (PT, DPT, MSHCA)
Entity Type:Individual
Prefix:DR
First Name:EDMER
Middle Name:
Last Name:LAZARO
Suffix:
Gender:M
Credentials:PT, DPT, MSHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 COLCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-9346
Mailing Address - Country:US
Mailing Address - Phone:415-724-5278
Mailing Address - Fax:
Practice Address - Street 1:164 COLCHESTER DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9346
Practice Address - Country:US
Practice Address - Phone:415-724-5278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist