Individual
KRISTIAN LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
327 RACE ST APT 2B, PHILADELPHIA, PA 19106-1834
(609) 304-5302
Mailing address
327 RACE ST APT 2B, PHILADELPHIA, PA 19106-1834
(609) 304-5302
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
25983601
PA
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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