Individual
LATESA HUDSON ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DHSC., MSHS, ATC
Contact information
Practice address
4871 SHIP JACK LN, DECATUR, GA 30035-3052
(229) 220-1036
Mailing address
4871 SHIP JACK LN, DECATUR, GA 30035-3052
(229) 220-1036
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001731
GA
Other
Enumeration date
12/30/2017
Last updated
12/30/2017
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