Individual
BARBARA BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6637 JEFFERSONIAN, WASHINGTON TWP, MI 48095-2450
(586) 752-9158
Mailing address
6637 JEFFERSONIAN, WASHINGTON TWP, MI 48095-2450
(586) 752-9158
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703056355
MI
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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