Individual
MR. LARRY DANTONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
290 BOWIE RD, THIBODAUX, LA 70301-6712
(985) 493-4502
(985) 493-4505
Mailing address
290 BOWIE RD, THIBODAUX, LA 70301-6712
(985) 493-4502
(985) 493-4505
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J00025
LA
Other
Enumeration date
08/15/2011
Last updated
08/15/2011
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