Basic Information
| Provider Information | |||||||||
| NPI: | 1518391994 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LASLEY | ||||||||
| FirstName: | RONALD | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 950243 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402950243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022531035 | ||||||||
| FaxNumber: | 5022531037 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 FOUNTAIN CT | ||||||||
| Address2: | SUITE 325 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405091895 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592630595 | ||||||||
| FaxNumber: | 8592630385 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2013 | ||||||||
| LastUpdateDate: | 02/04/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | T13032 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.