Individual
ANDREW LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
7105 HIGHWAY 9, FELTON, CA 95018-9718
(845) 558-7681
Mailing address
2015 FLINTCREST DR, SAN JOSE, CA 95148-1229
(845) 558-7681
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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