Provider Demographics
NPI:1063772424
Name:DUFRENE, CHAD ANTHONY (ATC)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:ANTHONY
Last Name:DUFRENE
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 1:1076 OAK HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-8258
Mailing Address - Country:US
Mailing Address - Phone:504-232-9589
Mailing Address - Fax:
Practice Address - Street 1:1076 OAK HOLLOW DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-8258
Practice Address - Country:US
Practice Address - Phone:504-232-9589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-19
Last Update Date:2012-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.2001962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer