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Individual

MR. FARON BLAKEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
728 E BROADWAY ST, CAMPBELLSVILLE, KY 42718-1504
(270) 465-4047
(270) 469-9747
Mailing address
728 E BROADWAY ST, CAMPBELLSVILLE, KY 42718-1504
(270) 465-4047
(270) 469-9747

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
494
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
203810955
TAX ID
KY
Enumeration date
12/11/2009
Last updated
12/11/2009
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