Individual
MRS. KACIE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1201 S CLEARVIEW PKWY, JEFFERSON, LA 70121-1015
(225) 571-9471
Mailing address
PO BOX 461, LIVINGSTON, LA 70754-0461
(225) 571-9471
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200362
LA
Other
Enumeration date
08/17/2015
Last updated
08/17/2015
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