Individual
MR. CHRISTIAN LASITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1505 SW 11TH ST APT B4, LAWTON, OK 73501-7376
(580) 284-0362
Mailing address
1505 SW 11TH ST APT B4, LAWTON, OK 73501-7376
(580) 284-0362
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
175T00000X
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000678763
—
OK
Enumeration date
02/20/2015
Last updated
02/20/2015
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