Jackson, Dominique Latia

Jackson, Dominique Latia is an individual health care provider with primary practice located at 812 W King St , Kings Mountain NC 28086-2748. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jackson, Dominique Latia can be contacted via phone (704) 739-5456.

Contact Information

Primary practice address
812 W King St Kings Mountain NC 28086-2748
Phone: (704) 739-5456
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0010-14318 North Carolina

Profile Details

NPI number 1841054392
LBN Legal business name Jackson, Dominique Latia
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2024
Last updated Jul 10th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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