Individual
RONALD LAYLON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
FORT LEWIS LANCER PERFORMANCE CENTER, 11371 22ND ST, TACOMA, WA 98433
(775) 240-0895
Mailing address
2195 LENTICULAR DR, SPARKS, NV 89441-4865
(775) 240-0895
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A161305038
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2022
Last updated
08/11/2022
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