Individual
MRS. LATONAH RANEE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
67 E MEADOW RD, MONTICELLO, FL 32344-5099
(850) 445-5094
Mailing address
67 E MEADOW RD, MONTICELLO, FL 32344-5099
(850) 445-5094
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
693584296
FL
Other
Enumeration date
05/07/2009
Last updated
05/07/2009
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