Grace Blackwelder, PTA

NPI #1326563594 in Jefferson, Louisiana

Provider Information

NPI Number: 1326563594
Entity Type: Individual
Name: Grace Blackwelder, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Aug 9, 2017
Last Updated: Jul 16, 2018

Practice Location

Address: 101 RIVER RD STE 112
City: Jefferson
State: Louisiana
ZIP Code: 70121
Phone: (504) 828-7696

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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