Individual
LATIA FLEWELLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8325 E JEFFERSON AVE, DETROIT, MI 48214-2797
(313) 566-4866
Mailing address
4875 CHALMERS ST, DETROIT, MI 48215-2162
(313) 566-4866
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501008822
MI
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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