Individual
AMIE BLACKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
781 CREEKWATER TER, APT 111, LAKE MARY, FL 32746-6063
(407) 925-4605
Mailing address
781 CREEKWATER TER, APT 111, LAKE MARY, FL 32746-6063
(407) 925-4605
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
PTA23405
FL
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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