Individual
EVAN DENOUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
216 WESTOVER DR APT 17D, HATTIESBURG, MS 39402-1375
(504) 615-8104
Mailing address
216 WESTOVER DR APT 17D, HATTIESBURG, MS 39402-1375
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0832
MS
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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