Individual
MAX WHITSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 GALLOWAY DR, HAMMOND, LA 70402-0001
(985) 549-5401
Mailing address
SOUTHEASTERN LOUISIANA UNIVERSITY ATHLETICS, SLU 10309, HAMMOND, LA 70402-0001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200384
LA
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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