Individual
COURTNEY BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD LD
Contact information
Practice address
209 SOUTHWOOD DR, COLUMBIA, SC 29205-3221
(642) 764-4718
Mailing address
209 SOUTHWOOD DR, COLUMBIA, SC 29205-3221
(642) 764-4718
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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