Individual
JOHN PARKER BLALOCK-CORNWEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN, CRCFA, ALCA
Contact information
Practice address
108 MCKELVEY PL, GOOSE CREEK, SC 29445-8215
(912) 341-7633
Mailing address
108 MCKELVEY PL, GOOSE CREEK, SC 29445-8215
(912) 341-7633
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN060987
GA
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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