Most Relevant Information
Provider Data
| NPI Number: | 1003418245 |
| Provider Name: | DOROTHY ANN LASTINE |
| Entity Type: | Individual |
| Taxonomy Code: | 374U00000X |
| Specialty: | Home Health Aide |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/12/2020 |
| Last Updated: | 11/12/2020 |
Provider Practice Location
1028 AMANDA CT SW
PINE ISLAND
MN
559636795
Practice Location Phone/Fax
| Phone: | 5072547523 |
| Fax: |
Provider Mailing Location
1028 AMANDA CT SW
PINE ISLAND
MN
559636795
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |