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Individual

MR. JOHN BLANKENSHIP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
109 LYTTLETON LN, MADISON HEIGHTS, VA 24572-2315
(434) 546-1504
Mailing address
109 LYTTLETON LN, MADISON HEIGHTS, VA 24572-2315
(434) 546-1504

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0001224739
VA

Other

Enumeration date
08/03/2013
Last updated
08/03/2013
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