Individual
MICHELLE DAWN BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 E BOYSON RD APT 606, HIAWATHA, IA 52233-1282
(319) 202-4825
Mailing address
125 E BOYSON RD APT 606, HIAWATHA, IA 52233-1282
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005091
IA
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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