Individual
LATASHA NICOLE TEMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1975 HIGHWAY 54 W, SUITE 210, FAYETTEVILLE, GA 30214-4794
(770) 632-2060
Mailing address
7304 CHADS CIR, JONESBORO, GA 30236-5702
(404) 725-7850
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001984
GA
Other
Enumeration date
11/08/2011
Last updated
11/08/2011
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