Individual
ALYSSA PAIGE LATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
575 COAL VALLEY RD STE 464, CLAIRTON, PA 15025-3740
(412) 267-6360
(412) 267-6361
Mailing address
575 COAL VALLEY RD STE 464, CLAIRTON, PA 15025-3740
(412) 267-6360
(412) 267-6361
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA060330
PA
363AS0400X
Surgical Physician Assistant
Primary
MA060330
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103598108
—
PA
01
—
14403474
CAQH
—
Enumeration date
01/10/2019
Last updated
02/02/2022
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