Individual
CANDICE MARIE LASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
597 WESTRIDGE CIR, DALLAS, GA 30132-9236
(678) 221-1369
Mailing address
PO BOX 552, DALLAS, GA 30132-0010
(678) 221-1369
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN086723
GA
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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