Individual
SARAH JANE WALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
800 E MCNEESE STREET, LAKE CHARLES, LA 70607
(337) 475-5219
Mailing address
6237 HAAG PL APT A, FORT POLK, LA 71459-3328
(601) 347-0780
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
320905
LA
Other
Enumeration date
09/26/2019
Last updated
03/21/2023
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