Provider Demographics
NPI:1295269306
Name:LASKI, STEPHEN (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:LASKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 NC HIGHWAY 55
Mailing Address - Street 2:STE 102
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7813
Mailing Address - Country:US
Mailing Address - Phone:919-544-4663
Mailing Address - Fax:919-544-6427
Practice Address - Street 1:5842 FAYETTEVILLE RD
Practice Address - Street 2:STE 111
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6294
Practice Address - Country:US
Practice Address - Phone:919-237-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012912111N00000X
NC4886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor