Provider Demographics
NPI:1972880821
Name:LASSETER, DARLA SUE (DC)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:SUE
Last Name:LASSETER
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 1:102 COLLEGE AVE
Mailing Address - Street 2:100 BEL AIR STREET
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-1606
Mailing Address - Country:US
Mailing Address - Phone:256-840-4000
Mailing Address - Fax:
Practice Address - Street 1:214 S MCCLESKEY ST
Practice Address - Street 2:SUITE 815
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35957-2117
Practice Address - Country:US
Practice Address - Phone:256-840-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2014-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor