Individual
KONSTANTINA BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26845 PRATT RD, SALISBURY, MD 21801-2277
(757) 710-3159
Mailing address
26845 PRATT RD, SALISBURY, MD 21801-2277
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R162920
MD
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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