Individual
DAMIAN LAWRENCE BREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT ATC
Contact information
Practice address
1307 OLD JEANERETTE RD STE 102, NEW IBERIA, LA 70563-5801
(800) 672-4504
Mailing address
1307 OLD JEANERETTE RD STE 102, NEW IBERIA, LA 70563-5801
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200156
LA
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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