Individual
ALYSSA BROOKE ROTENBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
220 JEFFERSON ST, NATCHITOCHES, LA 71457
(318) 357-4273
Mailing address
613 MARION ST, NATCHITOCHES, LA 71457-5519
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
125557986
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
BCBS
AL
Enumeration date
09/13/2017
Last updated
07/31/2018
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