Individual
WYDRICK RENELL HARDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 447-5500
Mailing address
635 BEACON DR, YOUNGSVILLE, LA 70592-5859
(337) 578-8310
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
302762
LA
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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