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Organization
LASA LLC
Active
Organization
LASA LLC
Active
Other names
Center For Industrial And Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA TRACY MCDANIEL PT (OWNER PHYSICAL THERAPIST)
(252) 672-9983
Entity
Organization
Contact information
Practice address
3268 WELLONS BLVD, NEW BERN, NC 28562
(252) 672-9983
(252) 672-9092
Mailing address
3268 WELLONS BLVD, NEW BERN, NC 28562
(252) 672-9983
(252) 672-9092
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012AR
BCBS
NC
05
—
7200100
—
NC
Enumeration date
10/23/2006
Last updated
08/22/2020
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