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Individual

DR. LIISA L LAAKSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
(703) 369-8073
(703) 369-8032
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0102206011
VA
2085R0202X
Diagnostic Radiology Physician
036058015
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01615363
BC GROUP
IL
05
036058015
IL
01
CB4562
TRAVELERS MEDICARE GRP
IL
01
P00386472
TRAVLERS INDIVIDUAL PIN
IL
Enumeration date
01/06/2006
Last updated
02/26/2024
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