Individual
RYAN ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C., L.A.T.
Contact information
Practice address
312 HERMITAGE DR, THIBODAUX, LA 70301-2917
(985) 859-8830
Mailing address
312 HERMITAGE DR, THIBODAUX, LA 70301-2917
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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