Lastine, Craig Lelland

Lastine, Craig Lelland is an individual health care provider with primary practice located at 2021 N 12Th St , Grand Junction CO 81501-2980. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Lastine, Craig Lelland can be contacted via phone (970) 242-0920.

Contact Information

Primary practice address
2021 N 12Th St Grand Junction CO 81501-2980
Phone: (970) 242-0920
Fax: (406) 587-1343
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X DR.0044010 Colorado

Profile Details

NPI number 1891753497
LBN Legal business name Lastine, Craig Lelland
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Dec 4th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891753497 NPPES
Montana MEDICAID 152524
Montana MEDICAID 06350003
Montana MEDICAID 0152507

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