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1659961837
WYDRICK RENELL HARDING
THIBODAUX, LA
NPI
1659961837
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: LA 302762)
Enumeration Date
2021-01-21
Last Update Date
2021-01-21
Business Address
WYDRICK RENELL HARDING ATC, LAT
602 N ACADIA RD
THIBODAUX, LA 70301-4823
Phone number: 985-447-5500
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Mailing Address
WYDRICK RENELL HARDING ATC, LAT
635 BEACON DR
YOUNGSVILLE, LA 70592-5859
Phone number: 337-578-8310
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