Individual
KELLY LAZAUSKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7019 NW CACHE RD, LAWTON, OK 73505
(580) 536-1279
Mailing address
15100 HIGHLAND LN, MINNETONKA, MN 55345-3619
(952) 930-3091
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
001503
IA
225200000X
Physical Therapy Assistant
1718-019
WI
225200000X
Physical Therapy Assistant
1977
OK
225200000X
Physical Therapy Assistant
941
NE
225200000X
Physical Therapy Assistant
Primary
A1346
MN
Other
Enumeration date
01/19/2011
Last updated
01/19/2011
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