Individual
MRS. JENNIFER ANN BLACKBURN
Active
Individual
MRS. JENNIFER ANN BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT009214
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000390391
ANTHEM
OH
05
—
2627170
—
OH
01
—
9429771
PHCS
OH
01
—
P00325333
MEDICARE RAILROAD
OH
Enumeration date
05/03/2006
Last updated
12/20/2013
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