Individual
KANE DAIGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
1020 W MAIN ST, VEVAY, IN 47043-9164
(225) 206-7391
Mailing address
6661 ARNETT RD, VEVAY, IN 47043-9063
(225) 206-7391
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200465
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ATH.200465
ATHLETIC TRAINER CERTIFICATION
LA
Enumeration date
12/06/2022
Last updated
12/06/2022
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