Individual
LATASHEANNA BLACKNALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2214 CUMINGS AVE, FLINT, MI 48503-3516
(810) 766-3227
Mailing address
2214 CUMINGS AVE, FLINT, MI 48503-3516
(810) 766-3227
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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