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Individual

ANNALISE HIMMEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
602 N ACADIA DR, THIBODAUX, LA 70302
(985) 859-6413
Mailing address
515 BACK PROJECT RD, SCHRIEVER, LA 70395

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
200309
LA

Other

Enumeration date
03/24/2016
Last updated
03/24/2016
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