Individual
KANETRIA LASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5066 PIONEER PKWY, MCDONOUGH, GA 30253-3040
(678) 356-6376
Mailing address
5066 PIONEER PKWY, MCDONOUGH, GA 30253-3040
(678) 356-6376
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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