Individual
RYAN TRAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT,ATC
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 493-4502
Mailing address
1748 RIDGEFIELD AVE, THIBODAUX, LA 70301-5302
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200279
LA
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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