Individual
DR. ALICIA HARRISON LAZESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15825 BALLANTYNE MEDICAL PL STE 100, CHARLOTTE, NC 28277-0745
(704) 323-3400
Mailing address
4601 PARK RD, SUITE 250, CHARLOTTE, NC 28209-3239
(704) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2015-01567
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689965162
—
NC
Enumeration date
05/02/2011
Last updated
01/07/2019
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