Provider Demographics
NPI:1063677201
Name:PARAMORE, LATALVIA (PT)
Entity Type:Individual
Prefix:MISS
First Name:LATALVIA
Middle Name:
Last Name:PARAMORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7606 HILLTOP WAY
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-7960
Mailing Address - Country:US
Mailing Address - Phone:404-375-7901
Mailing Address - Fax:
Practice Address - Street 1:3056 ANVIL BLOCK RD STE 118
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-2864
Practice Address - Country:US
Practice Address - Phone:404-366-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007375225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist