Individual
STEPHANIE A BLAYLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 E FRONT ST, BUCHANAN, MI 49107-1407
(574) 210-4728
Mailing address
207 E FRONT ST, BUCHANAN, MI 49107-1407
(574) 210-4728
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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