Individual
LATORE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5300 RIDGE FOREST DRIVE, STONE MOUNTAIN, GA 30083
(404) 399-7713
Mailing address
5825 LAKEVIEW CIR, LITHONIA, GA 30058-1843
(140) 439-9771
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN82505
GA
Other
Enumeration date
04/22/2015
Last updated
09/11/2020
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