Individual
DR. KAYLA M. LASOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11230 115TH ST AE3042, AUGUSTA, GA 30912
(706) 721-7005
Mailing address
11850 DR MLK JR ST N, APT 16206, ST. PETERSBURG, FL 33716
(716) 999-9999
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10973
GA
Other
Enumeration date
05/28/2019
Last updated
07/12/2019
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