Individual
CHETARA LATCHISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W BROADWAY STE 3C, COLUMBIA, MO 65203-3842
(573) 476-6416
(573) 476-6417
Mailing address
201 W BROADWAY STE 3C, COLUMBIA, MO 65203-3842
(573) 476-6416
(573) 476-6417
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M208357015
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99-3884284
NEMT
MO
Enumeration date
08/12/2025
Last updated
08/12/2025
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