Individual
BRETT LATTIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
8481 EAST PRONG ROAD, CANAAN, IN 47224
(812) 701-5946
Mailing address
8481 N EAST PRONG RD, CANAAN, IN 47224-9733
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002079A
IN
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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