Individual
MONTRAVON LATISE HERBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 S ELM ST STE 328, GREENSBORO, NC 27401-2681
(336) 491-9006
Mailing address
301 S ELM ST STE 328, GREENSBORO, NC 27401-2681
(336) 491-9006
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/04/2021
Last updated
05/13/2024
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