Individual
STEFANI BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
406 S MAIN ST, WINNSBORO, TX 75494-3226
(903) 342-6790
Mailing address
128 PATTERSON ST, COPPERAS COVE, TX 76522-4617
(325) 248-7751
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2153234
TX
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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