Individual
ZACHARY EDWARD LASKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3409 N ANTHONY BLVD, FORT WAYNE, IN 46805-2233
(765) 617-1890
(260) 484-0616
Mailing address
3409 N ANTHONY BLVD, FORT WAYNE, IN 46805-2233
(765) 617-1890
(260) 484-0616
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004220A
IN
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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