Individual
GAVIN LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CBCS
Contact information
Practice address
3672 MARATHON CIR STE 140, AUSTELL, GA 30106-6821
(470) 502-0202
Mailing address
321 SCOTLAND DR, DALLAS, GA 30132-2631
(678) 887-2779
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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