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Latonia Wallace
NPI 1770357733 · on the registry since 2023 · sole proprietor
Practice
- Address
- 577 Stable St
Pataskala, OH 43062 - Phone
- (380) 997-9972
- Organisation at this address
- Living Legendz Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 253Z00000X
253Z00000X
- Also registered as
- 251E00000X
376J00000X
385H00000X - Sex
- Female
- Record last updated
- 2024-07-31
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio