Individual
MISS JEAN JETTA BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMACY TECHNICIAN
Contact information
Practice address
2250 HICKORY RD STE 240, PLYMOUTH MEETING, PA 19462-2225
(610) 834-1122
(610) 825-1604
Mailing address
6518 REGENT ST, PHILADELPHIA, PA 19142-1909
(215) 729-2405
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
604178
PA
Other
Enumeration date
10/17/2007
Last updated
10/17/2007
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