Individual
MR. ALFRED RANDALL GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
15755 JEFFERSON HWY, BATON ROUGE, LA 70817-6313
(225) 753-1200
(225) 751-9269
Mailing address
15755 JEFFERSON HWY, BATON ROUGE, LA 70817-6313
(225) 753-1200
(225) 751-9269
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATHJ00072
LA
Other
Enumeration date
12/10/2014
Last updated
12/16/2014
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