NATALIA SUMODJO

LAKE CHARLES, LA
NPI1851886725
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: LA  306799)
Enumeration Date2018-06-24
Last Update Date2018-06-24
Business Address
NATALIA SUMODJO M.S., LAT, ATC, CES
5200 NELSON RD APT 516
LAKE CHARLES, LA 70605-0810
Phone number: 415-259-1403
Mailing Address
NATALIA SUMODJO M.S., LAT, ATC, CES
5200 NELSON RD APT 516
LAKE CHARLES, LA 70605-0810
Phone number: 415-259-1403
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