Individual
MR. JOHNNY EDGIL LATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DD,FIRST AID, WC
Contact information
Practice address
5126 TEALBY LN, SAINT LOUIS, MO 63128-2969
(314) 766-8294
Mailing address
5126 TEALBY LN, SAINT LOUIS, MO 63128-2969
(314) 766-8294
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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