Individual
FRANKLIN DALE LASTINGER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
10 W GROVE AVE, LAKE WALES, FL 33853-4516
(863) 678-6800
Mailing address
10 W GROVE AVE, LAKE WALES, FL 33853-4516
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12990
FL
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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