Individual
GARRETT S. LASALLE
Active
Individual
GARRETT S. LASALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
240055
NY
207R00000X
Internal Medicine Physician
42969
KY
207R00000X
Internal Medicine Physician
TD061090
ME
207R00000X
Internal Medicine Physician
TP781
KY
208VP0014X
Interventional Pain Medicine Physician
Primary
240055
NY
208VP0014X
Interventional Pain Medicine Physician
35.120779
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100079430
—
KY
Enumeration date
08/23/2006
Last updated
08/29/2022
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