Individual
MR. FRANCISCO LASTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L, CAPS
Contact information
Practice address
1658 W SUPERIOR ST APT 10, CHICAGO, IL 60622-7510
(312) 623-3875
Mailing address
1658 W SUPERIOR ST APT 10, CHICAGO, IL 60622-7510
(312) 623-3875
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
056007883
IL
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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