Organization
AHA MASSAGE CLINIC, L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DOMINIQUE ELIZABETH BLANCHARD L.M.T (OWNER)
(985) 872-4266
Entity
Organization
Contact information
Practice address
6270 W PARK AVE, HOUMA, LA 70364-2236
(985) 872-4266
(985) 872-4265
Mailing address
6270 W PARK AVE, HOUMA, LA 70364-2236
(985) 872-4266
(985) 872-4265
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LA3386
LA
Other
Enumeration date
08/05/2007
Last updated
04/20/2010
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