Healthcare Provider Details

I. General information

NPI: 1962541524
Provider Name (Legal Business Name): GARY STEVEN LASNESKI D.C., M.S., L.D.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 BAY RD SUITE 202
HADLEY MA
01035-9511
US

IV. Provider business mailing address

2 BAY RD SUITE 202
HADLEY MA
01035-9511
US

V. Phone/Fax

Practice location:
  • Phone: 413-587-3151
  • Fax: 413-587-3153
Mailing address:
  • Phone: 413-587-3151
  • Fax: 413-587-3153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1464
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: