Individual
KYLE JAMES BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HIS
Contact information
Practice address
1106 W WILLOW RD, ENID, OK 73703-2503
(580) 234-4343
Mailing address
1106 W WILLOW RD, ENID, OK 73703-2503
(580) 234-4343
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1206
OK
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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