Individual
MR. KENNETH LEE LATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
169 MEDICAL DR, PEARSALL, TX 78061-6604
(830) 334-3371
Mailing address
101 W GOODWIN AVE STE 600, VICTORIA, TX 77901-6530
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2018479
TX
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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