Individual
EMILY BLACKBOURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35640 W MICHIGAN AVE, WAYNE, MI 48184-1628
(734) 729-7938
Mailing address
35640 W MICHIGAN AVE, WAYNE, MI 48184-1628
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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