Individual
SAMUEL BLACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(505) 325-0238
Mailing address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(505) 325-0238
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NM
Other
Enumeration date
05/30/2025
Last updated
12/03/2025
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