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Individual

MRS. DAPHNE REENE BLAKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-8913
(573) 884-1070
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004396
GA
363A00000X
Physician Assistant
Primary
2024033212
MO

Other

Enumeration date
08/28/2007
Last updated
11/06/2024
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