Individual
MARK LEE BLANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
310 CLOVERLEAF SQ STE A1, BIG STONE GAP, VA 24219-3074
(276) 523-2100
(276) 523-2101
Mailing address
310 CLOVERLEAF SQ STE A1, BIG STONE GAP, VA 24219-3074
(276) 523-2100
(276) 523-2101
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0202010024
VA
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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