Individual
ERIC BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
248 CIRCLE DR, SOUTH HILL, VA 23970
(434) 247-1047
Mailing address
248 CIRCLE DR, SOUTH HILL, VA 23970-3305
(434) 247-1047
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T69517889
VA
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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