Individual
MRS. MERRILYN BLACKMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RT (R) (M)
Contact information
Practice address
700 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559
(907) 543-6000
Mailing address
PO BOX 1347, BETHEL, AK 99559-1347
(907) 543-5703
Taxonomy
Speciality
Code
Description
License number
State
2471M2300X
Mammography Radiologic Technologist
Primary
—
—
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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