Individual
GREGORY C BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2551 17TH ST NW APT 312, WASHINGTON, DC 20009-2851
(202) 765-8287
Mailing address
2551 17TH ST NW APT 312, WASHINGTON, DC 20009-2851
(202) 765-8287
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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