Individual
LATHEN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
326 CHARDONNAY AVE, PROSSER, WA 99350-9515
(509) 786-6626
Mailing address
715 S 19TH AVE, YAKIMA, WA 98902-4219
(509) 895-9291
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
60031762
WA
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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