Individual
DR. GARY L LATIMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
267 BROOKLYN ST, SUITE A, CARBONDALE, PA 18407-2836
(570) 282-1240
(570) 282-7937
Mailing address
267 BROOKLYN ST, SUITE A, CARBONDALE, PA 18407-2836
(570) 282-1240
(570) 282-7937
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC004100L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2322827930
TAX ID #
PA
01
—
590360
BLUE SHIELD ID #
PA
Enumeration date
11/13/2006
Last updated
08/28/2012
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