Individual
SHADERRE LASSITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
182 BUTLER ST, WILKES BARRE, PA 18702-4465
(888) 510-2095
Mailing address
423 SCOTT ST APT 2, WILKES BARRE, PA 18702-5539
(888) 510-2095
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
61133
PA
Other
Enumeration date
09/16/2025
Last updated
09/17/2025
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