Individual
MR. KEVIN BRIAN HARGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1112 S AVENUE F, CROWLEY, LA 70526-6130
(337) 842-0809
Mailing address
1112 S AVENUE F, CROWLEY, LA 70526-6130
(337) 842-0809
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200199
LA
Other
Enumeration date
06/01/2012
Last updated
06/01/2012
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