Individual
TIFFANY GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT,
Contact information
Practice address
1221 S CLEARVIEW PKWY, JEFFERSON, LA 70121-1011
(337) 349-4927
Mailing address
12500 OLD HAMMOND HWY APT N1, BATON ROUGE, LA 70816-1094
(337) 349-4927
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.J00296
LA
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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