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Organization

DONALD W BLOCKER DO

Active
Parent organization
DONALD W BLOCKER OD
Other names
Portland Vision Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
DONALD W BLOCKER OD
Authorized official
DONALD W BLOCKER OD (OWNER OPTOMETRIST)
(615) 325-2020
Entity
Organization

Contact information

Practice address
605 S BROADWAY, PORTLAND, TN 37148-1619
(615) 325-2020
(615) 325-5862
Mailing address
PO BOX 470, PORTLAND, TN 37148-0470
(615) 325-2020
(615) 325-5862

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Enumeration date
06/05/2007
Last updated
10/24/2014
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