Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand |
NPI | 1902378912 |
---|---|
Provider Name | Latonya Yvonne Williams |
First Address | Bartlett, TN 38134-3440 |
Second Address | Bartlett, TN 38134-3440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2019 |
Last Update Date | 02/01/2019 |