SHANE BLACKA

JEFFERSON, LA
NPI1437998663
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-05-20
Last Update Date2024-05-20
Business Address
SHANE BLACKA
1514 JEFFERSON HWY
JEFFERSON, LA 70121-2429
Phone number: 504-842-3000
Mailing Address
SHANE BLACKA
1514 JEFFERSON HWY
JEFFERSON, LA 70121-2429
Phone number: