Individual
ANDREW PAUL LASTOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
151 EAST 3RD STREET, PALISADE, CO 81526
(970) 464-7500
Mailing address
430 KEENER ST, GRAND JUNCTION, CO 81504-4723
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
CO
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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