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Individual

MORGAN SHYANNE LATTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSFA

Contact information

Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Mailing address
85775 S 4680 RD, STILWELL, OK 74960-9117

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
212952
OK

Other

Enumeration date
05/29/2025
Last updated
05/29/2025
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