Provider Demographics
NPI:1346024981
Name:HIGHTOWER, LATOYA RENECE
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:RENECE
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 HOLSTON DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3908
Mailing Address - Country:US
Mailing Address - Phone:850-559-1422
Mailing Address - Fax:
Practice Address - Street 1:1952 HOLSTON DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3908
Practice Address - Country:US
Practice Address - Phone:850-559-1422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory