Individual
CORDARIUS WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
216 W UNION ST STE A, MINDEN, LA 71055-3216
(318) 299-6334
(318) 299-6332
Mailing address
100 S LAKE CIR, MONROE, LA 71203-6947
(318) 537-0280
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
300123
LA
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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