Individual
MRS. DIANE LATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
355 RIDGE AVENUE, EVANSTON, IL 60202-9985
(847) 316-4000
(847) 316-2758
Mailing address
355 RIDGE AVENUE, EVANSTON, IL 60202-9985
(847) 316-4000
(847) 316-2758
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.003560
IL
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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