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Organization

DRS GOUGH & LATHAM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DARLA LATHAM O.D. (PARTNER)
(336) 768-9262
Entity
Organization

Contact information

Practice address
1010 S STRATFORD RD, WINSTON SALEM, NC 27103-3206
(336) 768-9262
(336) 768-4481
Mailing address
1010 S STRATFORD RD, WINSTON SALEM, NC 27103-3206
(336) 768-9262
(336) 768-4481

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
NC1353
NC

Other

Enumeration date
09/12/2008
Last updated
09/12/2008
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