Individual
MADISEN E FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 CAJUNDOME BLVD, LAFAYETTE, LA 70506-4271
(337) 482-6279
Mailing address
225 CAJUNDOME BLVD, LAFAYETTE, LA 70506-4271
(337) 482-6279
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
343829
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/30/2023
Last updated
09/03/2024
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