Individual
DESARAE LATINO-DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Contact information
Practice address
10 PARTRIDGE RD, GROTON, CT 06340-4323
(860) 445-5220
Mailing address
10 PARTRIDGE RD, GROTON, CT 06340-4323
(860) 445-5220
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
303
CT
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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