Individual
EBONY BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 JOHN MOTLEY DR, CHERAW, SC 29520-3419
(240) 721-0746
Mailing address
15 JOHN MOTLEY DR, CHERAW, SC 29520-3419
(240) 721-0746
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/23/2021
Last updated
05/23/2021
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