Individual
JUSTIN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
700 E MCNEESE ST, LAKE CHARLES, LA 70607-5832
(337) 475-5219
Mailing address
700 E MCNEESE ST, LAKE CHARLES, LA 70607-5832
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
303780
LA
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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