Individual
MRS. KIMBERLY LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.,C.
Contact information
Practice address
201 PENNSYLVANIA PKWY, SUITE 100, INDIANAPOLIS, IN 46280-2301
(317) 817-1252
Mailing address
201 PENNSYLVANIA PKWY, SUITE 100, INDIANAPOLIS, IN 46280-2301
(317) 817-1252
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000469A
IN
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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