Individual
RYAN LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2173 CENTERVILLE PL STE A, TALLAHASSEE, FL 32308-8303
(848) 448-0603
Mailing address
60 DEBORAH LN, HOWELL, NJ 07731-3504
(848) 448-0603
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA307
FL
Other
Enumeration date
07/10/2015
Last updated
09/24/2015
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