Individual
HEATHER LEIGH THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2030 14TH ST BLDG 1830, FORT POLK, LA 71459-5302
(559) 908-5545
Mailing address
904 MARJORIE ST, LONG BEACH, MS 39560-5349
(228) 313-1680
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
320823
LA
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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