NPI 1114231529

Sandra Lasam, PT

Practitioner Specialist Hazelwood, MO

Practice location

Address: 1 Village Sq STE a, Hazelwood, MO 63042-1817
Phone: (314) 731-4555
Fax: (314) 551-6110

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 107653 (MO)

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Registry record

NPI: 1114231529
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Jul 2010
Record last updated: 28 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.