Individual
LATASHA PAULETTE GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4955 SUGARLOAF PKWY STE F, LAWRENCEVILLE, GA 30044-6997
(800) 324-2688
Mailing address
1530 MISTY VALLEY DR, LAWRENCEVILLE, GA 30045-7033
(770) 539-5662
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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