Individual
KAITLIN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1557 SMEDE HWY, BROUSSARD, LA 70518-8117
(337) 365-1416
Mailing address
PO BOX 53055, LAFAYETTE, LA 70505-3055
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
303187
LA
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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