Organization
DAVID C BLACKMON,PHD,PSYCH SVC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID C BLACKMON PHD (PRESIDENT)
(904) 333-3389
Entity
Organization
Contact information
Practice address
482 JACKSONVILLE DR, JACKSONVILLE BEACH, FL 32250-3812
(904) 333-3389
(904) 246-6703
Mailing address
482 JACKSONVILLE DR, JACKSONVILLE BEACH, FL 32250-3812
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY4360
FL
Other
Enumeration date
12/27/2011
Last updated
01/03/2012
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