Individual
MRS. VIVA A. LATTIMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
205 SOUTH FRONT STREET, 4TH FLOOR, BMA, HARRISBURG, PA 17104-1619
(717) 231-8555
(717) 231-8568
Mailing address
205 SOUTH FRONT STREET, 4TH FLOOR, BMA, HARRISBURG, PA 17104
(717) 231-8555
(717) 231-8568
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA00300L
PA
363AM0700X
Medical Physician Assistant
Primary
MA003300L
PA
Other
Enumeration date
05/12/2006
Last updated
11/06/2023
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