Individual
KELLY A BLOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
429 S 3RD ST, GADSDEN, AL 35901-5210
(256) 547-8634
(254) 547-3039
Mailing address
429 S 3RD ST, GADSDEN, AL 35901-5210
(256) 547-8634
(254) 547-3039
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S570TA289
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S570TA289
STATE LICENSE
AL
Enumeration date
07/06/2006
Last updated
07/08/2007
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