Individual
LA'TORIA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1434 CENTRAL AVE E, WIGGINS, MS 39577-9602
(601) 928-1889
Mailing address
1436 CENTRAL AVE E, WIGGINS, MS 39577-9602
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 4590
MS
Other
Enumeration date
06/20/2016
Last updated
10/29/2019
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