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ALARIC REMINGTON LANE BLACKWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSA

Contact information

Practice address
PO BOX 64, FLORENCE, KY 41022-0064
(859) 957-9975
Mailing address
PO BOX 64, FLORENCE, KY 41022-0064
(859) 957-9975

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1204754
KY

Other

Enumeration date
05/24/2022
Last updated
05/14/2024
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