IndividualActive
Latricia Irvine
NPI 1689108052 · Contractor · Valdosta, GA
Latricia Irvine is a Contractor provider in Valdosta, GA (NPI 1689108052).
Provider details
- NPI number
- 1689108052
- Entity type
- Individual
- Primary specialty
- ContractorOther Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 17002279 (GA)
Practice location
3813 Trotters Ridge Cir
Valdosta, GA 31605-4892
Phone: (504) 344-4646
Street-level locationGet directions
Mailing address
3813 Trotters Ridge Cir
Valdosta, GA 31605-4892
Registry dates
- Enumerated
- 2017-04-12
- Last updated
- 2017-04-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.