Individual
DAVID WAYNE LASSITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
106 MAJESTIC DR, APT. 4, EDMONTON, KY 42129-8109
(270) 432-4049
Mailing address
PO BOX 331, EDMONTON, KY 42129-0331
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT429
KY
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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