Individual
CARMEN L. LASTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.V.M.
Contact information
Practice address
456 KOKOPELLI BLVD UNIT E, FRUITA, CO 81521-8723
(970) 858-4299
Mailing address
2076 VICTORIAN LN, GRAND JUNCTION, CO 81505-8308
(970) 201-5191
Taxonomy
Speciality
Code
Description
License number
State
174M00000X
Veterinarian
Primary
3964
OK
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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