Blackwell Jr, Jerry D

Blackwell Jr, Jerry D is an sole proprietor health care provider with primary practice located at 2498 Pineridge St , Thibodaux LA 70301-3959. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Blackwell Jr, Jerry D can be contacted via phone (985) 446-7573.

Contact Information

Primary practice address
2498 Pineridge St Thibodaux LA 70301-3959
Phone: (985) 446-7573
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X J00235 Louisiana

Profile Details

NPI number 1598473860
LBN Legal business name Blackwell Jr, Jerry D
Credentials Licensed Athletic Trainer (LAT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2022
Last updated Nov 7th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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