Individual
ELISE LATTIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 GEORGE BUSBEE PKWY NW, APT. 808, KENNESAW, GA 30144-6637
(678) 522-9030
Mailing address
815 ATLANTA HIGHWAY, CUMMING, GA 30040
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002148
GA
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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