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General NPI Number Information
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NPI Number | 1619093457
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Entity Type | Individual
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Provider Name | TONJA G. LATHAM P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3235 PERKINS RD
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City | BATON ROUGE
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State | LA
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Zip | 70808-2256
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Country | US
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Telephone | 615-778-4066
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Fax | 615-778-9114
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Provider Business Mailing Address
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Address Line | 720 COOL SPRINGS BLVD SUITE 300
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City | FRANKLIN
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State | TN
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Zip | 37067-2626
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Country | US
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Telephone | 615-778-4066
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Fax | 615-778-9114
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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 | 02286
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License Number State | LA
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