TRAVIS EDWARD THERIOT

LAKE CHARLES, LA
NPI1104570027
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: LA  ATH.200301)
Enumeration Date2022-02-09
Last Update Date2022-02-09
Business Address
TRAVIS EDWARD THERIOT MS, LAT, ATC
1747 IMPERIAL BLVD
LAKE CHARLES, LA 70605-5362
Phone number: 337-721-7236
Mailing Address
TRAVIS EDWARD THERIOT MS, LAT, ATC
1747 IMPERIAL BLVD
LAKE CHARLES, LA 70605-5362
Phone number: 337-329-3923
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