Individual
TOMMY BLANCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
4820 HIGHWAY 1, RACELAND, LA 70394-2627
(985) 532-3319
Mailing address
1934 HIGHWAY 654, GHEENS, LA 70355-2202
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200176
LA
Other
Enumeration date
05/10/2016
Last updated
05/10/2016
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