Individual
AMANDA BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
412 CITICO ST, KNOXVILLE, TN 37921-5811
(865) 522-0661
Mailing address
412 CITICO ST, KNOXVILLE, TN 37921-5811
(865) 522-0661
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
J6B9C3P9
TN
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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