Individual
REAGAN CLAIRE SKIDMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
800 GALLOWAY DRIVE, HAMMOND, LA 70402-3339
(985) 549-5133
Mailing address
17017 CULPS BLUFF AVE, BATON ROUGE, LA 70817-3339
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
323947
LA
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/08/2019
Last updated
08/13/2021
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