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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