Individual
JACK CHAIM LASOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5600 HOBBS RD, KEVIL, KY 42053-9685
(270) 441-6266
(270) 441-6208
Mailing address
5600 HOBBS RD, KEVIL, KY 42053-9685
(270) 441-6266
(270) 441-6208
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA020
KY
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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