Organization
LATORE WILLIAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATORE WILLIAMS (LPN)
(404) 399-7713
Entity
Organization
Contact information
Practice address
5300 RIDGE FOREST DR, STONE MOUNTAIN, GA 30083-3882
(404) 399-7713
Mailing address
5300 RIDGE FOREST DR, STONE MOUNTAIN, GA 30083-3882
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN082505
GA
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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