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Individual

CARTER BLACKHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
370 EAST SOUTH TEMPLE, SUITE 100, SALT LAKE CITY, UT 84102
(801) 363-3926
Mailing address
840 TWIN LAKES DR, UNIT 415, ST GEORGE, UT 84770-3161
(435) 669-9191

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8661479-2401
UT

Other

Enumeration date
01/10/2014
Last updated
01/10/2014
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