Individual
STACY L. BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
800 BLACKHAWK AVENUE, PRAIRIE DU CHIEN, WI 53821
(608) 326-0808
(608) 326-0810
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(608) 785-0940
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52150
WI
Other
Enumeration date
09/19/2008
Last updated
09/16/2020
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