Individual
LAUREN SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
612 E WORTHY ST, GONZALES, LA 70737-4241
(225) 391-6100
Mailing address
612 E WORTHY ST, GONZALES, LA 70737-4241
(225) 391-6100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200103
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ATH.200103
LOUISIANA STATE BOARD OF MEDICAL EXAMINERS
LA
Enumeration date
08/21/2012
Last updated
08/21/2012
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