Provider Demographics
NPI:1578885893
Name:LASH, COLBY D (ATC)
Entity Type:Individual
Prefix:MR
First Name:COLBY
Middle Name:D
Last Name:LASH
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-3412
Mailing Address - Country:US
Mailing Address - Phone:970-261-0528
Mailing Address - Fax:906-227-2848
Practice Address - Street 1:1401 PRESQUE ISLE AVE
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-5305
Practice Address - Country:US
Practice Address - Phone:906-227-2665
Practice Address - Fax:906-227-2848
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer