Organization
PROFESSIONAL HOME SLEEP STUDIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY STREAT LASTINGER I (OWNER)
(912) 384-8535
Entity
Organization
Contact information
Practice address
75 DRAKE DR, DOUGLAS, GA 31535-7279
(912) 384-8535
Mailing address
75 DRAKE DR, DOUGLAS, GA 31535-7279
(912) 384-8535
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Enumeration date
04/30/2009
Last updated
04/30/2009
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