Provider Demographics
NPI:1063525855
Name:GIARDINA, DAVID J (ATC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:GIARDINA
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 WINGATE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-6572
Mailing Address - Country:US
Mailing Address - Phone:225-615-7644
Mailing Address - Fax:
Practice Address - Street 1:29301 N. DIXIE RANCH RD.
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445-2290
Practice Address - Country:US
Practice Address - Phone:985-871-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAJ000012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer