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General NPI Number Information
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NPI Number | 1912511627
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Entity Type | Individual
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Provider Name | MRS. VERTA LATIMORE
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Gender | Female
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 270 PERRY LN
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City | UNION CITY
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State | GA
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Zip | 30291-3412
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Country | US
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Telephone | 770-375-7149
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82651
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City | HAPEVILLE
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State | GA
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Zip | 30354-0651
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Country | US
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Telephone | 770-284-0402
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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