Provider Demographics
NPI:1912161811
Name:LASKEY, ANDREA LEIGH (DPT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:LEIGH
Last Name:LASKEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 LEWIS HILL RD
Mailing Address - Street 2:
Mailing Address - City:BOWDOIN
Mailing Address - State:ME
Mailing Address - Zip Code:04287-7324
Mailing Address - Country:US
Mailing Address - Phone:207-650-7068
Mailing Address - Fax:207-747-0408
Practice Address - Street 1:44 ELM ST
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1418
Practice Address - Country:US
Practice Address - Phone:207-650-7068
Practice Address - Fax:207-747-0408
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME3417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist