EVAN DAUTERIVE

THIBODAUX, LA
NPI1134589443
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: LA  ATH.200454)
Enumeration Date2016-02-29
Last Update Date2016-02-29
Business Address
-- EVAN DAUTERIVE ATC
602 N ACADIA RD
THIBODAUX, LA 70301-4823
Phone number: 985-448-4837
Mailing Address
-- EVAN DAUTERIVE ATC
602 N ACADIA RD
THIBODAUX, LA 70301-4823
Phone number:
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