Individual
DONALD BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6020 CONSTITUTION AVE NE STE 4, ALBUQUERQUE, NM 87110-5931
(505) 255-5099
Mailing address
PO BOX 3338, ALBUQUERQUE, NM 87190-3338
(505) 255-5099
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1496
NM
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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