MEDICARE: DR. JODIE MARIE LASKY DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X013371	NY

General Provider Information

NPI Number	:	1104441542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JODIE MARIE LASKY DC

Provider Business Mailing Address
First Line	:	4385 RECREATION DR
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-2232
Country	:	US
Telephone Number	:	585-704-0348
Fax Number	:	888-974-2190

Provider Business Practice Location Address
First Line	:	4385 RECREATION DR
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-2232
Country	:	US
Telephone Number	:	585-905-0036
Fax Number	:	585-905-0081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2020
Last Update Date	:	02/10/2026

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