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NPI Code Detail

MEDICARE: MS. HEATHER DAY LASSITER PT

MEDICARE: MS. HEATHER DAY LASSITER PT
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
1225100000XPhysical Therapist011771OH
2225100000XPhysical Therapist2305205454VA

General Provider Information

NPI Number : 1700046380
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HEATHER DAY LASSITER PT
Provider Business Mailing Address
First Line : 5604 VIRGINIA BEACH BLVD STE 101
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-5631
Country : US
Telephone Number : 757-455-5000
Fax Number : 757-319-4142
Provider Business Practice Location Address
First Line : 5604 VIRGINIA BEACH BLVD STE 101
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-5631
Country : US
Telephone Number : 757-455-5000
Fax Number : 757-319-4142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2008
Last Update Date : 04/17/2020

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Directions to “ MS. HEATHER DAY LASSITER PT” Practice Location

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