Individual
CHARLES LOUIS BLAZEK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2240 N ROAN ST, JOHNSON CITY, TN 37601-2521
(423) 283-4942
Mailing address
134 AVONLEA PL, JOHNSON CITY, TN 37604-1708
(804) 898-1505
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000033123
TN
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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