Individual
LAURA KATHRYN TASTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
306 WESTWOOD AVE STE 401, HIGH POINT, NC 27262-4342
(336) 885-6168
Mailing address
306 WESTWOOD AVE STE 401, HIGH POINT, NC 27262-4342
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0010-09301
NC
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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