Individual
DR. HEATHER MCCOY BLACKISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2316 PULASKI HWY STE B, NORTH EAST, MD 21901-3730
(410) 642-9110
(410) 642-9113
Mailing address
2316 PULASKI HWY STE B, NORTH EAST, MD 21901-3730
(410) 642-9110
(410) 642-9113
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
02079
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2912304
AETNA INS
—
01
—
61670301
CAREFIRST BC
—
Enumeration date
05/08/2006
Last updated
08/03/2021
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