Individual
MR. BRUCE M. BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.P.T., C.W.S.
Contact information
Practice address
818 HIGH ST, SUITE 1, CHESTERTOWN, MD 21620-1152
(410) 778-6565
(410) 778-6536
Mailing address
818 HIGH ST, SUITE 1, CHESTERTOWN, MD 21620-1152
(410) 778-6565
(410) 778-6536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18889
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405156400
—
MD
Enumeration date
10/26/2006
Last updated
06/05/2023
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