| Doctor Name: | KEVIN LEE LASER |
| NPI Number: | 1780641340 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 40QAO1113200 |
| Business Practice Address: | 700 S White Horse Pike Suite D Somerdale, NJ - 080831253 |
| Business Phone Number: | 8565046930 |
| Business Fax Number: | 8565046934 |
| Mailing Address: | 700 S White Horse Pike, Suite D SOMERDALE |
| State: | NJ |
| Postal Code: | 080831253 |
| Phone Number: | 8565046930 |
| Fax Number: | 8565046934 |
| NPI Enumeration Date: | 04/27/2006 |
| NPI Last Update Date: | 10/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 40QAO1113200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |