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Individual

MR. BRYAN PAUL BLACKWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CHC

Contact information

Practice address
6801 SIOUX AVE, YUCCA VALLEY, CA 92284-2679
(760) 895-8233
Mailing address
6801 SIOUX AVE, YUCCA VALLEY, CA 92284-2679
(760) 895-8233

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
NY

Other

Enumeration date
06/07/2023
Last updated
06/07/2023
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