Individual
MR. EDWARD TERRELL BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
304 NEWBURY ST, STE 114, BOSTON, MA 02115-2839
(617) 372-5907
Mailing address
581 BOYLSTON ST, STE 406, BOSTON, MA 02116-3608
(617) 372-5907
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9471
MA
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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