Individual
JOSE SALAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, CES, CSCS
Contact information
Practice address
202 ALLISON LN, LA PORTE, IN 46350-5266
(636) 212-2508
Mailing address
202 ALLISON LN, LA PORTE, IN 46350-5266
(636) 212-2508
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
36002364A
IN
2255A2300X
Athletic Trainer
AL 3851
FL
2255A2300X
Athletic Trainer
Primary
AT5408
TX
Other
Enumeration date
08/11/2014
Last updated
12/04/2015
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