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Individual

MR. JOSHUA ROBERT LAFONTAINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.T.C.

Contact information

Practice address
1501 MENDOCINO AVE, SANTA ROSA, CA 95401-4332
(707) 527-4323
Mailing address
4864 HOEN AVE, SANTA ROSA, CA 95405-7452

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
02/07/2017
Last updated
02/07/2017
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