Individual
SANDI LATIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1185 JAMUNDA WALK APT D, SAINT LOUIS, MO 63129-1849
(314) 262-6518
Mailing address
1185 JAMUNDA WALK APT D, SAINT LOUIS, MO 63129-1849
(314) 262-6518
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
344600000X
Taxi
—
—
347C00000X
Private Vehicle
—
—
347E00000X
Transportation Broker
—
—
Other
Enumeration date
03/01/2024
Last updated
04/27/2025
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