Provider Demographics
NPI:1437879483
Name:HASTIE, KARA (LMT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:HASTIE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 SE 46TH CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-3261
Mailing Address - Country:US
Mailing Address - Phone:304-419-7399
Mailing Address - Fax:
Practice Address - Street 1:109 E JOE P STRICKLAND JR AVE
Practice Address - Street 2:
Practice Address - City:BUSHNELL
Practice Address - State:FL
Practice Address - Zip Code:33513-6116
Practice Address - Country:US
Practice Address - Phone:352-282-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA-95804225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist