Individual
LAURA DIANNE LAIDACKER FIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 441-2163
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA056698
PA
363AS0400X
Surgical Physician Assistant
MA056698
PA
Other
Enumeration date
01/27/2014
Last updated
04/04/2022
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