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Individual

ROYAL MILTON III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
1121 W JACQUELINE ST, GONZALES, LA 70737-3708
(504) 875-9656
Mailing address
PO BOX 1511, GONZALES, LA 70707-1511

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
07/14/2014
Last updated
07/14/2014
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