Individual
JOHAN LATORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.S
Contact information
Practice address
SRC 190 1717 6TH AVE S, BIRMINGHAM, AL 35294-0001
(205) 975-8298
Mailing address
SRC 190 1717 6TH AVE S, BIRMINGHAM, AL 35294-0001
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
4351026956
MI
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
44926
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2017
Last updated
06/30/2023
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