Individual
MR. TERRY ALAN BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
319 MERCY ST, LAKE CITY, SC 29560-2331
(843) 374-2825
(843) 374-9914
Mailing address
15250 HWY 301, NEW ZION, SC 29111-9560
(843) 659-4033
(843) 374-9914
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5491
SC
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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