Individual
SHENIECE M LATTIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
87 S ASHBURTON RD, COLUMBUS, OH 43213-1687
(614) 633-0774
(614) 633-0774
Mailing address
87 S ASHBURTON RD, COLUMBUS, OH 43213-1687
(614) 633-0774
(614) 633-0774
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
3078397
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3078397
—
OH
Enumeration date
07/01/2014
Last updated
07/01/2014
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