Individual
JORDAN ELIZABETH BLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1201 S CLEARVIEW PKWY, JEFFERSON, LA 70121-1015
(504) 736-4800
Mailing address
1212 FOCIS ST, METAIRIE, LA 70005-2318
(941) 356-7483
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200209
LA
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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