Individual
DANIEL BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
719B SE MAIN ST, SIMPSONVILLE, SC 29681-3237
(864) 963-9229
Mailing address
719B SE MAIN ST, SIMPSONVILLE, SC 29681-3237
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7507
SC
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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