Organization
LASER SPORT & SPINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILAN LASSITER D.C. (OWNER/CHIROPRACTOR)
(804) 254-5765
Entity
Organization
Contact information
Practice address
1303 W MAIN ST, RICHMOND, VA 23220-4851
(804) 254-5765
(804) 254-5763
Mailing address
10350 KILBY CT, MECHANICSVILLE, VA 23116-5825
(804) 254-5765
(804) 254-5763
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
0104-555801
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972714079
DOCTOR'S PRIOR INDIVIDUAL NPI #
VA
Enumeration date
02/15/2014
Last updated
02/15/2014
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