Provider Demographics
NPI:1710597539
Name:LASTER, LINDSEY LILLIAN (PTA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:LILLIAN
Last Name:LASTER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 WILLOW TREE DR
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-6187
Mailing Address - Country:US
Mailing Address - Phone:508-277-6998
Mailing Address - Fax:
Practice Address - Street 1:146 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:BUZZARDS BAY
Practice Address - State:MA
Practice Address - Zip Code:02532-3902
Practice Address - Country:US
Practice Address - Phone:508-759-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8498225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty