Individual
LUSTAN ORLANDO LETTS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2390 E FLORIDA AVE, HEMET, CA 92544-4707
(951) 765-1474
(951) 765-1476
Mailing address
16270 HERITAGE GROVE RD, RIVERSIDE, CA 92504-5221
(951) 237-8304
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5501
CA
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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