Individual
LATISHA HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1173 E HINES ST, REPUBLIC, MO 65738-1277
(417) 735-0055
Mailing address
1173 E HINES ST, REPUBLIC, MO 65738-1277
(417) 735-0055
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
2022033873
MO
Other
Enumeration date
06/26/2025
Last updated
08/07/2025
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