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Individual

CHAD B BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
HIS

Contact information

Practice address
106 W 27TH ST, SCOTTSBLUFF, NE 69361-4304
(308) 632-5633
(308) 632-5939
Mailing address
PO BOX 238, SCOTTSBLUFF, NE 69363-0238
(308) 632-5633
(308) 632-5939

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
189
WY
237700000X
Hearing Instrument Specialist
Primary
800
NE
237700000X
Hearing Instrument Specialist
HAD8556
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
237700000X
NE
Enumeration date
10/19/2016
Last updated
10/19/2016
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