Individual
LATASHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 WESTGATE DR STE 601, DURHAM, NC 27707-2568
(919) 748-4124
Mailing address
3500 WESTGATE DR STE 601, DURHAM, NC 27707-2568
(919) 748-4124
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
R6Z5S3D8
NC
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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