Individual
LATONYA M HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
691 PINECREST AVE APT C5, BEDFORD, VA 24523-2857
(434) 213-5157
Mailing address
691 PINECREST AVE APT C5, BEDFORD, VA 24523-2857
(434) 213-5157
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T60477113
VA
Other
Enumeration date
05/23/2021
Last updated
05/23/2021
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