Provider Demographics
NPI:1477540979
Name:CASTLE, RALPH RAY (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:RAY
Last Name:CASTLE
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3286 WESTERVELT AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-5034
Mailing Address - Country:US
Mailing Address - Phone:225-769-4982
Mailing Address - Fax:
Practice Address - Street 1:LSU DEPARTMENT OF KINESIOLOGY
Practice Address - Street 2:112 HUEY P. LONG FIELDHOUSE
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70803-0001
Practice Address - Country:US
Practice Address - Phone:225-578-7175
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAJ001292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer