Individual
KEVIN BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1040 CHESTERFIELD HWY, CHERAW, SC 29520-7010
(843) 537-2741
Mailing address
1040 CHESTERFIELD HWY, CHERAW, SC 29520-7010
(843) 537-2741
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12324
SC
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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