Search › Louisiana › 2255A2300X
Jerry Blackwell Jr, LAT
NPI 1598473860 · on the registry since 2022 · sole proprietor
Practice
- Address
- 2498 Pineridge St
Thibodaux, LA 70301 - Phone
- (985) 446-7573
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-11-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana