Individual
MR. QUANTRELL ELIJAH RASHAD TOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3347 MASONIC DR, ALEXANDRIA, LA 71301-3842
(318) 664-6682
Mailing address
4900 LISA ST APT 64, ALEXANDRIA, LA 71302-2326
(504) 908-1134
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
200018
LA
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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