Individual
DR. TIMOTHY RICHARD LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C. M.S. LDN CSCS
Contact information
Practice address
665 BOYLSTON ST STE 3, BOSTON, MA 02116-4825
(724) 554-2795
Mailing address
146 EDINBORO ST, NEWTON, MA 02460-1302
(724) 554-2795
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
3532
MA
133N00000X
Nutritionist
3868
MA
Other
Enumeration date
02/09/2010
Last updated
07/28/2020
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