MEDICARE: MR. CHRISTOPHER CURT LAHAYE ATC,LAT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	ATH.200015	LA

General Provider Information

NPI Number	:	1508828351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER CURT LAHAYE ATC,LAT

Provider Business Mailing Address
First Line	:	1916 B MEMORIAL DRIVE
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-0000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 MASONIC DRIVE
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-0000
Country	:	US
Telephone Number	:	318-840-3171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	07/08/2007

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