Individual
ANNMARIE ASIS LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
499 BECKETT RD, SUITE 201, LOGAN TOWNSHIP, NJ 08085-1766
(856) 467-6400
(856) 467-1033
Mailing address
499 BECKETT RD, SUITE 201, LOGAN TOWNSHIP, NJ 08085-1766
(856) 467-6400
(856) 467-1033
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00306200
NJ
363AM0700X
Medical Physician Assistant
MA056009
PA
Other
Enumeration date
04/23/2013
Last updated
10/04/2013
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