Individual
MR. BYRON BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1202 SUNSET DR, BOGALUSA, LA 70427-8710
(985) 735-1426
(985) 735-1428
Mailing address
1202 SUNSET DR, BOGALUSA, LA 70427-8710
(985) 735-1426
(985) 735-1428
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT07163R
LA
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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