Individual
DAVIDA LASHAE LATTIMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
724 KENILWORTH AVE, DAYTON, OH 45405-4044
(937) 838-6681
Mailing address
2130 W 3RD ST, DAYTON, OH 45417-2542
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
SQ270187
OH
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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