Individual
MISS KAITLYN RENEE BIRCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W UNIVERSITY AVE, HAMMOND, LA 70401-1304
(985) 549-2000
Mailing address
17626 HOOPER RD, GREENWELL SPRINGS, LA 70739-5743
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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