Provider Demographics
NPI:1578741567
Name:LASETER, CHRISTOPHER THOMAS (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:LASETER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GOOD DR
Mailing Address - Street 2:4
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4349
Mailing Address - Country:US
Mailing Address - Phone:717-394-2071
Mailing Address - Fax:717-394-2077
Practice Address - Street 1:101 GOOD DR
Practice Address - Street 2:4
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4349
Practice Address - Country:US
Practice Address - Phone:717-394-2071
Practice Address - Fax:717-394-2077
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008714L204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01626917Medicaid
F41699Medicare UPIN
LA169298Medicare PIN