Individual
MRS. CANDACE JENELL CROSS LASSITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 MOUNTAIN ASHE PL, HAMPTON, VA 23666-2175
(757) 825-1660
Mailing address
4 MOUNTAIN ASHE PL, HAMPTON, VA 23666-2175
(757) 825-1660
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602453
VA
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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