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General NPI Number Information
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NPI Number | 1225328677
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Entity Type | Individual
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Provider Name | RONALD P. LECLAIR JR. MSED,ATC,L, CSCS,ROT
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Gender | Male
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 235 WELLESLEY ST
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City | WESTON
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State | MA
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Zip | 02493-1572
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Country | US
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Telephone | 781-768-7066
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Fax | 781-768-8329
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Provider Business Mailing Address
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Address Line | 235 WELLESLEY ST
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City | WESTON
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State | MA
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Zip | 02493-1572
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Country | US
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Telephone | 617-233-9856
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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 |
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License Number State |
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