Individual
RACHIELLE BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6441 BRICE DALE DR, CANAL WINCHESTER, OH 43110-8584
(614) 800-0906
Mailing address
6441 BRICE DALE DR, CANAL WINCHESTER, OH 43110-8584
(614) 800-0906
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
RX862458
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0190460
—
OH
Enumeration date
12/12/2016
Last updated
12/12/2016
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