MEDICARE: RENE' LATELLA D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	579-0100	NH
2	111N00000X	Chiropractor	X009558-1	NY
3	111N00000X	Chiropractor	4299	NC

General Provider Information

NPI Number	:	1447226725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENE' LATELLA D.C

Provider Business Mailing Address
First Line	:	108 TALICUD TRL
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27539-9781
Country	:	US
Telephone Number	:	919-916-0618
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 PRESTON EXECUTIVE DR STE 100D
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-8488
Country	:	US
Telephone Number	:	919-371-8844
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	05/19/2023

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Directions to “ RENE' LATELLA D.C” Practice Location

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