Individual
RUSTY LASSITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3235 W PARADISE DR, PHOENIX, AZ 85029-2328
(480) 390-8171
Mailing address
3235 W PARADISE DR, PHOENIX, AZ 85029-2328
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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