Individual
CASSANDRA COLLETTE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
250 PARK ST, BOWLING GREEN, KY 42101-1760
(270) 796-6540
Mailing address
250 PARK ST, BOWLING GREEN, KY 42101-1760
(276) 219-9281
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R6473
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2021
Last updated
06/28/2023
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