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1114520061
DAVID BLAINE LAHERTY
ALLEN, TX
NPI
1114520061
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2020-11-20
Last Update Date
2020-11-20
Business Address
-- DAVID BLAINE LAHERTY
411 SHADYWOOD DR
ALLEN, TX 75002-1659
Phone number: 385-231-9995
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Mailing Address
-- DAVID BLAINE LAHERTY
411 SHADYWOOD DR
ALLEN, TX 75002-1659
Phone number: 385-231-9995
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