Individual
MR. EUGENE C BLACKWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21351 GEORGETOWN RD, FRANKFORT, IL 60423-3008
(815) 464-0524
Mailing address
21351 GEORGETOWN RD, FRANKFORT, IL 60423-3008
(815) 464-0524
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051033017
IL
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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