Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 14618 | TX |
NPI | 1003405630 |
---|---|
Provider Name | Dr. Latonya Harris |
First Address | Oak Point, TX 75068-0709 |
Second Address | Dallas, TX 75208-4512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2021 |
Last Update Date | 18/01/2021 |