Individual
TERRI LYNN BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
851 LEONARD FULGHUM DR STE 101, MOUNT PLEASANT, SC 29464-3793
(843) 971-9350
Mailing address
1300 HOSPITAL DR STE 150, MOUNT PLEASANT, SC 29464-3243
(843) 971-9350
(843) 971-9351
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TL 1833
SC
Other
Enumeration date
10/03/2012
Last updated
06/12/2019
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