Individual
JAIMIE BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
425 CUMBERLAND ST, CHATTANOOGA, TN 37404-1909
(423) 698-0802
Mailing address
425 CUMBERLAND ST, CHATTANOOGA, TN 37404-1909
(423) 698-0802
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
80270
TN
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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