Individual
LAURA VESTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
457 N MAIN ST, LA GRANGE, TX 78945-1937
(979) 968-3144
Mailing address
701 BOHLMANN AVE, SCHULENBURG, TX 78956-1315
(979) 743-4750
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211895
TX
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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