Individual
TAMICA BLANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2853 REVELS AVE, DAYTON, OH 45417
(937) 321-1705
Mailing address
2853 REVELS AVE, DAYTON, OH 45417-4226
(937) 321-1705
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401746600515
OH
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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