Individual
ADRIAN BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
2512 DOUGLAS AVE, KOKOMO, IN 46902-3370
(765) 461-3734
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006364A
IN
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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