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General NPI Number Information
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NPI Number | 1790700540
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Entity Type | Individual
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Provider Name | DANIEL L DOUCET M.S.,ATC, LAT,LCEP
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 N LEWIS ST
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City | NEW IBERIA
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State | LA
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Zip | 70563-2043
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Country | US
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Telephone | 377-277-1782
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Fax | 337-374-4391
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Provider Business Mailing Address
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Address Line | 268 MONTEIGNE DR
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City | LAFAYETTE
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State | LA
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Zip | 70506-5424
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Country | US
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Telephone | 337-277-1782
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Fax | 337-374-4391
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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 | JOOO14
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License Number State | LA
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