Individual
EBONY GLASCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, EMT
Contact information
Practice address
800 GALLOWAY DR, HAMMOND, LA 70402-0001
(985) 549-6501
Mailing address
1502 W CHURCH ST APT E, HAMMOND, LA 70401-2959
(770) 833-2908
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
306450
LA
Other
Enumeration date
07/23/2017
Last updated
07/23/2017
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