Individual
JONATHAN DANIEL BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REC. THERAPIST
Contact information
Practice address
77 CENTRAL AVE STE E, ASHEVILLE, NC 28801-2451
(828) 277-1315
Mailing address
PO BOX 802, ASHEVILLE, NC 28802-0802
(828) 277-1315
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
3564
NC
Other
Enumeration date
08/11/2018
Last updated
05/26/2023
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