Individual
HOLLIE BETH BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
83 MITCHELL LN, GILBERT, WV 25621-9722
(304) 953-4475
Mailing address
PO BOX 1752, GILBERT, WV 25621-1752
(304) 953-4475
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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