Basic Information
Provider Information
NPI: 1770663858
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LASHER
FirstName: MARIE
MiddleName: NOEL
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 430 INNOVATION DRIVE
Address2:  
City: BLAIRSVILLE
State: PA
PostalCode: 157178096
CountryCode: US
TelephoneNumber: 7243434060
FaxNumber: 7243434069
Practice Location
Address1: ONDICH RURAL HEALTH CENTER ROUTE 85 EAST
Address2:  
City: YATESBORO
State: PA
PostalCode: 16263
CountryCode: US
TelephoneNumber: 7247837192
FaxNumber: 7247836830
Other Information
ProviderEnumerationDate: 10/16/2006
LastUpdateDate: 01/14/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT005177LPAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
20906601PAHEALTH AMER/HEALTH ASSUR.OTHER
554676101PAAETNAOTHER
00043351801PAHIGHMARK BLUE SHIELDOTHER


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