Individual
LATHANIKONE LANGSTON LOUPRASONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6010
(937) 395-8162
Mailing address
3737 SOUTHERN BLVD STE 2100, KETTERING, OH 45429-1285
(937) 433-5309
(937) 298-0287
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
50003874
OH
363A00000X
Physician Assistant
Primary
50.003874
OH
Other
Enumeration date
09/23/2013
Last updated
01/18/2021
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