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1982316204
KEVIN LASTOVA
FAIRFAX, VA
NPI
1982316204
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2022-12-19
Last Update Date
2022-12-19
Business Address
KEVIN LASTOVA PA
8270 WILLOW OAKS CORPORATE DR STE 700
FAIRFAX, VA 22031-4529
Phone number: 703-277-2663
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Mailing Address
KEVIN LASTOVA PA
6022 COPELY LN
MC LEAN, VA 22101-2507
Phone number: 571-249-9754
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