Individual
LATOYA CALLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 DOVE ST, MELBOURNE, FL 32935-9005
(321) 667-1362
Mailing address
1015 DOVE ST, MELBOURNE, FL 32935-9005
(321) 667-1362
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
L21000431795
FL
Other
Enumeration date
07/08/2022
Last updated
07/08/2022
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