Individual
LATRICE ANTRAE LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
919 NORTH 25TH STREET, 6-101, FORT PIERCE, FL 34950
(772) 882-2705
Mailing address
913 NW 12TH ST, OKEECHOBEE, FL 34972-2041
(772) 519-4201
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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