Individual
LATONDA E HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3789 BLACKTHORN CT, ORANGE PARK, FL 32073-2290
(904) 887-3951
Mailing address
3789 BLACKTHORN CT, ORANGE PARK, FL 32073-2290
(904) 887-3951
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
L20000019124
FL
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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