Latia Tisdale
NPI #1699307520 in North Chesterfield, Virginia
Provider Information
- NPI Number
- 1699307520
- Entity Type
- Individual
- Name
- Latia Tisdale
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist
- Enumeration Date
- Feb 8, 2020
- Last Updated
- Feb 8, 2020
Practice Location
- Address
- 2520 PROFESSIONAL RD STE D
- State
- Virginia
- ZIP Code
- 23235-3267
- Phone
- (804) 601-4447
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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