Individual
LATARCHIA S WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2116 W STATE ST, TAMPA, FL 33606-1048
(813) 770-1964
(813) 512-8473
Mailing address
2116 W STATE ST, TAMPA, FL 33606-1048
(813) 770-1964
(813) 512-8473
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
23558
FL
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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