Individual
ANTHONY BAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9677 FLORIDA BLVD, WALKER, LA 70785-7205
(225) 664-4825
Mailing address
50296 RIVERS RD, TICKFAW, LA 70466-6017
(985) 981-9697
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
306002
LA
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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