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Individual

LATOSHA MARIE HARPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, DPT, MPT, ATC

Contact information

Practice address
N112W17975 MEQUON RD, GERMANTOWN, WI 53022-2425
(262) 532-7600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
73617
WI
225100000X
Physical Therapist
10112-024
WI
363A00000X
Physician Assistant
2017007775
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100101658
WI
Enumeration date
01/03/2009
Last updated
07/08/2024
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