Individual
BRENT M BLEVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, RRT,MS
Contact information
Practice address
141 KYLE MALIA RDG, ASHLAND, KY 41102-7960
(304) 399-4969
(304) 399-4969
Mailing address
141 KYLE MALIA RDG, ASHLAND, KY 41102-7960
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
59357
WV
Other
Enumeration date
10/26/2012
Last updated
10/26/2012
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