Individual
DR. BLAKE JENNEWEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-3000
Mailing address
300 JOSHUA PL NW APT 12, CONCORD, NC 28027-0199
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
31377
NC
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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