Individual
MR. PAUL LEWIS LASTOVA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
9860 LEE HWY, SUITE 1, FAIRFAX, VA 22030-1702
(703) 383-1616
(703) 383-1166
Mailing address
9860 LEE HWY, SUITE 1, FAIRFAX, VA 22030-1702
(703) 383-1616
(703) 383-1166
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/24/2005
Last updated
07/08/2007
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