Individual
JAMIE LASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RCS
Contact information
Practice address
2413 SAINT ANDREWS CT, MUSKOGEE, OK 74403-1682
(918) 910-4067
(918) 910-4065
Mailing address
2413 SAINT ANDREWS CT, MUSKOGEE, OK 74403-1682
(918) 910-4067
(918) 910-4065
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
00090586
OK
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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