Individual
LATIFAH TEYONNA REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Mailing address
7230 SANSOM ST, UPPER DARBY, PA 19082-3405
(484) 904-2001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
J3-0000664
DE
2255A2300X
Athletic Trainer
Primary
RT006405
PA
Other
Enumeration date
07/21/2016
Last updated
02/08/2017
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