Individual
LATISHA MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9299 CHIPPEWA TRL, KELSEYVILLE, CA 95451-9696
(707) 245-6546
Mailing address
9299 CHIPPEWA TRL, KELSEYVILLE, CA 95451-9696
(707) 245-6546
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003947A
IN
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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