Individual
KRISTA BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2590 S ADAMS RD, ROCHESTER HILLS, MI 48309-5508
(248) 810-9274
Mailing address
9414 WAH LO HI DR, CLARKSTON, MI 48348-3276
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/23/2016
Last updated
09/24/2023
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