Individual
JENNIFER LASTOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7675 SWEET HOURS WAY, COLUMBIA, MD 21046-2477
(410) 290-5282
Mailing address
7675 SWEET HOURS WAY, COLUMBIA, MD 21046-2477
(410) 290-5282
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17770
MD
225100000X
Physical Therapist
PT2127
DC
Other
Enumeration date
03/16/2007
Last updated
01/06/2012
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