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Organization
LAFOUCHE PARISH SCHOOL BOARD
Active
Organization
LAFOUCHE PARISH SCHOOL BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY DALE BLACKWELL JR. LAT (HEAD ATHLETIC TRAINER)
(985) 859-5359
Entity
Organization
Contact information
Practice address
1355 TIGER DR, THIBODAUX, LA 70301-4236
(985) 859-5359
Mailing address
1355 TIGER DR, THIBODAUX, LA 70301-4236
(985) 859-5359
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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