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Individual

LARISSA MARIA HATALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
211 OLD LEXINGTON RD, THOMASVILLE, NC 27360-3428
(336) 474-4770
(336) 474-4779
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 474-4770
(336) 474-4779

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
SC006469
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
632
NC

Other

Enumeration date
08/07/2013
Last updated
05/03/2022
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