Individual
SARA MACKENSIE FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N STADIUM DR, BATON ROUGE, LA 70803-0001
(225) 579-2050
Mailing address
2209 CEDARDALE AVE, BATON ROUGE, LA 70808-2812
(512) 740-2524
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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