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Mr. Paul Lewis Lastova, PT
Specialist in Fairfax, Virginia
NPI 1033102157

Paul Lewis Lastova is a Specialist based in Fairfax, VA. Paul Lewis Lastova practices in Fairfax, VA and has the professional credentials of PT. The NPI Number for Paul Lewis Lastova is 1033102157 and holds a License No. (Virginia).

The current practice location address for Paul Lewis Lastova is 9860 Lee Hwy, Fairfax, VA and can be reached out via phone at 703-383-1616 and via fax at 703-383-1166.

Location: 9860 Lee Hwy, Fairfax, VA, 22030-1702
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033102157
Provider Name
Paul Lewis Lastova
Credential
PT
Provider Entity Type
Individual
Gender
Male
Address
9860 Lee Hwy, Fairfax, VA, 22030-1702
Phone Number
703-383-1616
Fax Number
703-383-1166
Provider Enumeration Date
08/24/2005
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
9860 Lee Hwy
City
Fairfax
State
Virginia
Zip
22030-1702
Phone Number
703-383-1616
Fax Number
703-383-1166
person
Provider Business Mailing Address Details
Address
9860 Lee Hwy
City
Fairfax
State
Virginia
Zip
22030-1702
Phone Number
703-383-1616
Fax Number
703-383-1166
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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