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1235371717
JACOB ISAAC LATHAM
BOLIVAR, TN
NPI
1235371717
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2009-03-31
Last Update Date
2009-03-31
Business Address
JACOB ISAAC LATHAM BS
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008-3587
Phone number: 731-658-6113
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Mailing Address
JACOB ISAAC LATHAM BS
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008-3587
Phone number: 731-658-6113
Copy
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