Individual
LATORIA GABRIEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
127 OLD HIGHWAY 98 E STE C, COLUMBIA, MS 39429-8172
(601) 674-0260
Mailing address
1493 GATES RD, COLUMBIA, MS 39429-9085
(601) 596-8638
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
334971
MS
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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