Individual
MR. BRAD MICHAEL PENOUILH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, ATC, LAT
Contact information
Practice address
710 WEST DR, WESTWEGO, LA 70094-4736
(504) 810-9111
Mailing address
710 WEST DR, WESTWEGO, LA 70094-4736
(504) 810-9111
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/17/2006
Last updated
02/26/2009
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