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General NPI Number Information
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NPI Number | 1780471359
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Entity Type | Individual
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Provider Name | MRS. ANGELA CHIRSTINE LASKEWITZ
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Gender | Female
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 630 FREEPORT AVE NW SUITE 100
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City | ELK RIVER
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State | MN
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Zip | 55330
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Country | US
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Telephone | 863-441-3830
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Fax |
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Provider Business Mailing Address
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Address Line | 75859 US HIGHWAY 218
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City | BLOOMING PRAIRIE
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State | MN
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Zip | 55917-4901
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Country | US
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Telephone | 507-438-4927
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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