Individual
EDWARD AVERY BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2460 INDIA HOOK RD STE AND105, ROCK HILL, SC 29732-3530
(803) 366-6250
Mailing address
3008 TYLER CT, INDIAN LAND, SC 29707-7489
(864) 838-8045
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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