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MS. ALYSSA DAWN LATHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
9100 SAN MATEO BLVD NE APT 2053, ALBUQUERQUE, NM 87113-2605
(859) 620-2204

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006091RX
OH

Other

Enumeration date
11/02/2018
Last updated
09/03/2021
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