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General NPI Number Information
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NPI Number | 1114565967
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Entity Type | Individual
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Provider Name | MINDY LANGLOIS MA, ATC, CSCS, ITAT
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Gender | Female
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 29401 SW 125TH AVE BUILDING 741
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City | HOMESTEAD
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State | FL
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Zip | 33039-1615
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Country | US
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Telephone | 616-638-1357
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Fax |
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Provider Business Mailing Address
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Address Line | 29401 SW 125TH AVE BUILDING 600
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City | HOMESTEAD
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State | FL
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Zip | 33039-0001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 003118
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License Number State | NY
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