Individual
LILAH MICHELLE BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 712-2000
Mailing address
11465 HOLLY FERN CT, SAN DIEGO, CA 92131-3739
(858) 395-0213
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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