Individual
GARY ROBERT BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 S 9TH ST, SUITE 17, NOBLESVILLE, IN 46060-2717
(317) 774-0969
(317) 774-5741
Mailing address
14098 MEADOW LAKE DR, FISHERS, IN 46038-5587
(317) 774-0969
(317) 774-5741
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/23/2013
Last updated
07/03/2013
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