Charlotte Latham, PTA
Individual provider Active NPI Physical Therapy Assistant · Los Ranchos, NM
NPI 1013343219 · NPPES record last updated Sep 19, 2013
Key facts
- NPI
- 1013343219
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- A-0889 (NM)
- Practice address
- 8631 Rio Grande Blvd NW Apt C
Los Ranchos, NM 87114-1200 - Phone
- (505) 231-4131
- NPI assigned
- Sep 19, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-0889 | NM | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A-0889 | NM | Yes |
Addresses
Primary practice location
8631 Rio Grande Blvd NW Apt C
Los Ranchos, NM 87114-1200
Mailing address
PO Box 56843
Albuquerque, NM 87187-6843
Phone (505) 231-4131
Other providers in Los Ranchos, NM
- Shannon King
- Knackstedt Medical Group Inc.
- Shirley Knackstedt
- Sedona Kolchinsky
- Jacob Kualapai
- Virginia Marie Lawlor
- Sherry Lynn Lebeznick Brown
- Denise Lengyel
- Angelica Lopez
- Elizzabeth Lopez
All providers in Los Ranchos, NM · Physical Therapy Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.