Individual
MRS. LORESA LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 11TH AVE, MOLINE, IL 61265-1498
(309) 757-7744
Mailing address
221 11TH AVE, MOLINE, IL 61265-1498
(309) 757-7744
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.003895
IL
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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