Individual
DANIEL ANTHONY LATOURELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
712 HAYTER STREET, NACOGDOCHES, TX 75962-0001
(936) 468-3784
Mailing address
4541 NE STALLINGS DR APT 701, NACOGDOCHES, TX 75965-1672
(707) 758-4593
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7935
TX
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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