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Organization
TOM LATRIELLE D C PA
Active
Organization
TOM LATRIELLE D C PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM C LATRIELLE DC (OFFICER)
(954) 553-2222
Entity
Organization
Contact information
Practice address
1900 S OCEAN DR, SUITE 807, FORT LAUDERDALE, FL 33316-3763
(954) 553-2222
Mailing address
1900 S OCEAN DR, SUITE 807, FORT LAUDERDALE, FL 33316-3763
(954) 553-2222
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0007390
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70024
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/03/2006
Last updated
08/22/2020
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