Individual
LYNNAIRE JASTILLANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1625 N 4TH ST, TERRE HAUTE, IN 47804-4067
(812) 232-8716
Mailing address
1625 N 4TH ST, TERRE HAUTE, IN 47804-4067
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002099A
IN
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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