Individual
BRENTON LATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
PO BOX 860912, MINNEAPOLIS, MN 55486-0912
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070022132
IL
225100000X
Physical Therapist
Primary
PT 30630
FL
225100000X
Physical Therapist
Primary
PT30630
FL
Other
Enumeration date
08/28/2015
Last updated
04/08/2026
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