Individual
DOREEN BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 YELLOW SPRINGS RD, ELIZABETHTOWN, IL 62931-4447
(618) 289-4339
Mailing address
110 YELLOW SPRINGS RD, ELIZABETHTOWN, IL 62931-4447
(618) 289-4339
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
MO
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
11/01/2019
Last updated
11/01/2019
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