Individual
MS. LISA G LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 OVERLAND LN, BRANDON, MS 39047-7947
(601) 992-5419
Mailing address
215 OVERLAND LN, BRANDON, MS 39047-7947
(601) 992-5419
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0559
MS
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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