Individual
MISTY BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
571 25 RD STE 520, GRAND JUNCTION, CO 81505-1303
(970) 654-0511
Mailing address
4649 W RD, DE BEQUE, CO 81630-9604
(970) 773-1952
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
CO
Other
Enumeration date
05/28/2026
Last updated
05/28/2026
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