Individual
MR. NICHOLAS OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
389 HIGHWAY 21 STE 403, MADISONVILLE, LA 70447-3441
(985) 792-5996
Mailing address
17579 ALACK DR, HAMMOND, LA 70403-0243
(985) 969-3691
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200186
LA
Other
Enumeration date
08/21/2011
Last updated
08/21/2011
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