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1356124317
GRANT SCOTT LATHAM
JOPLIN, MO
NPI
1356124317
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-08-15
Last Update Date
2023-08-15
Business Address
GRANT SCOTT LATHAM
3001 SAINT JOHNS BLVD
JOPLIN, MO 64804-1884
Phone number: 417-208-0805
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Mailing Address
GRANT SCOTT LATHAM
3001 SAINT JOHNS BLVD
JOPLIN, MO 64804-1884
Phone number: 417-208-0805
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