Individual
BRADEN PATRICK JARRARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, NREMT
Contact information
Practice address
906 E 1ST ST, THIBODAUX, LA 70301-6701
(887) 642-4655
Mailing address
3838 BLACKSTOCK RD, TALMO, GA 30575-2025
(770) 533-2007
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
306671
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000028562
ATHLETIC TRAINER
LA
Enumeration date
04/30/2018
Last updated
04/30/2018
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