Individual
MATTHEW BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
PO BOX 217, LIBERTY, MS 39645-0217
(601) 657-8051
(601) 657-8049
Mailing address
PO BOX 217, LIBERTY, MS 39645-0217
(601) 657-8051
(601) 657-8049
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-12682
MS
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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