Individual
LATRECIA ANTOINETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
296 BEAUVOIR RD STE 1005120, BILOXI, MS 39531-4051
(601) 514-2533
Mailing address
296 BEAUVOIR RD STE 1005120, BILOXI, MS 39531-4051
(601) 514-2533
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
11/30/2023
Last updated
01/02/2024
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