Individual
MATTHEW BLACKBURN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
422 BUCKINGHAM GRV, WADSWORTH, OH 44281-6237
(330) 573-3319
Mailing address
422 BUCKINGHAM GRV, WADSWORTH, OH 44281-6237
(330) 573-3319
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT012226
OH
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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