Individual
TERSHON BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, STE 240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
1512 W FAIRMOUNT AVE, BALTIMORE, MD 21223-1780
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A00034126
MD
Other
Enumeration date
11/12/2007
Last updated
11/12/2007
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