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General NPI Number Information
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NPI Number | 1033571757
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Entity Type | Individual
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Provider Name | MOLLY D LEBLANC M.ED, ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 762 N MAIN ST
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City | SAINT MARTINVILLE
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State | LA
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Zip | 70582-4125
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Country | US
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Telephone | 337-394-3135
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Fax |
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Provider Business Mailing Address
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Address Line | 202 KATHRYN ST
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City | NEW IBERIA
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State | LA
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Zip | 70560-1016
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Country | US
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Telephone | 337-967-3075
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | ATH:200111
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License Number State | LA
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