Individual
DAKOTA JAMES BLACKWELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-STUDENT
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(570) 801-7418
Mailing address
1115 MARNE BLVD, HINESVILLE, GA 31313-8092
(707) 480-3327
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/16/2025
Last updated
10/16/2025
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