Individual
KERRY BLACKSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 AUSTIN GRAYBILL RD, NORTH AUGUSTA, SC 29860-9251
(803) 278-4272
Mailing address
350 AUSTIN GRAYBILL RD, NORTH AUGUSTA, SC 29860-9251
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
000658
GA
225100000X
Physical Therapist
Primary
564
SC
Other
Enumeration date
08/01/2013
Last updated
08/01/2013
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