Individual
GARRETT BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 353-6051
Mailing address
2081 CHULA BROOKFIELD RD, TIFTON, GA 31794-2662
(229) 402-4430
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
7724
GA
Other
Enumeration date
09/14/2015
Last updated
11/19/2020
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