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General NPI Number Information
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NPI Number | 1346650843
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Entity Type | Individual
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Provider Name | SCOTT GIARDINA
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Gender | Male
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 05/06/2014
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Provider Practice Location Address
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Address Line | 1910 W MAIN ST
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City | LUTCHER
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State | LA
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Zip | 70071-5122
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Country | US
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Telephone | 225-869-5741
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Fax |
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Provider Business Mailing Address
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Address Line | 8672 FOXFIELD DR
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City | BATON ROUGE
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State | LA
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Zip | 70809-5218
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Country | US
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Telephone | 504-339-4460
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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 | ATH.20009
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License Number State | LA
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