Individual
DUSTIN LEE BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCTMB, NCP, LMT
Contact information
Practice address
103 W 5TH ST, TUSCUMBIA, AL 35674-2411
(256) 200-9431
Mailing address
103 W 5TH ST, TUSCUMBIA, AL 35674-2411
(256) 200-9431
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3081
AL
Other
Enumeration date
03/07/2018
Last updated
03/07/2018
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