Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist | SC |
NPI | 1356929285 |
---|---|
Provider Name | Latasha Battle |
First Address | Spartanburg, SC 29301-2678 |
Second Address | Greenville, SC 29607-6540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2021 |
Last Update Date | 31/03/2021 |