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Individual

DR. COREY S. BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1932 ASPEN CIR STE A, GRAND ISLAND, NE 68803-2474
(308) 646-0077
(308) 646-0317
Mailing address
PO BOX 5823, GRAND ISLAND, NE 68802-5823
(308) 646-0077
(308) 646-0317

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
341
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1528350485
NPI
NE
Enumeration date
05/11/2011
Last updated
12/23/2022
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