Individual
AUSTIN BLACKMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1663 STEPHENSON HWY, TROY, MI 48083-2169
(231) 313-4569
Mailing address
612 S CENTER ST APT 203, ROYAL OAK, MI 48067-3838
(231) 313-4569
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010034
MI
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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