Provider Demographics
NPI:1548610868
Name:LATSHAW, NATALIE (DPT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:LATSHAW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1563
Mailing Address - Street 2:
Mailing Address - City:AVALON
Mailing Address - State:CA
Mailing Address - Zip Code:90704-1563
Mailing Address - Country:US
Mailing Address - Phone:310-510-0700
Mailing Address - Fax:310-510-2938
Practice Address - Street 1:100 FALLS CANYON ROAD
Practice Address - Street 2:
Practice Address - City:AVALON
Practice Address - State:CA
Practice Address - Zip Code:90704-1563
Practice Address - Country:US
Practice Address - Phone:310-510-0700
Practice Address - Fax:310-510-2938
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294665225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist