LARRY BLACKBURN

WILLIAMSON, WV
NPI1033712443
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2020-11-18
Last Update Date2020-11-18
Business Address
LARRY BLACKBURN
1626 W 3RD AVE
WILLIAMSON, WV 25661-3007
Phone number: 304-235-1701
Mailing Address
LARRY BLACKBURN
PO BOX 1406
WILLIAMSON, WV 25661-1406
Phone number: 304-235-1701
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