Alexis J Amato, LAT, ATC

Individual provider Active NPI Athletic Trainer · Deridder, LA

NPI 1972019529 · NPPES record last updated Dec 19, 2017

Key facts

NPI
1972019529
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
303132 (LA)
Practice address
600 S Pine St
Deridder, LA 70634-4942
Phone
(337) 396-2071
NPI assigned
Dec 19, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
303132LAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 303132 LA Yes

Addresses

Primary practice location

600 S Pine St
Deridder, LA 70634-4942

Mailing address

1439 Highway 3226
Deridder, LA 70634-9131
Phone (985) 517-0383

Other providers in Deridder, LA

All providers in Deridder, LA · Athletic Trainer in Louisiana

Sources for this page

Verify at the official NPI Registry.