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General NPI Number Information
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NPI Number | 1063677201
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Entity Type | Individual
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Provider Name | LATALVIA PARAMORE PT
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Gender | Female
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3056 ANVIL BLOCK RD STE 118
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City | ELLENWOOD
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State | GA
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Zip | 30294-2864
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Country | US
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Telephone | 404-366-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 7606 HILLTOP WAY
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City | COLLEGE PARK
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State | GA
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Zip | 30349-7960
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Country | US
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Telephone | 404-375-7901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT007375
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License Number State | GA
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