Individual
KATIE BLACKBOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10600 W 21ST ST N, WICHITA, KS 67205-1886
(316) 729-5914
Mailing address
10600 W 21ST ST N, WICHITA, KS 67205-1886
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-15156
KS
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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