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1124034483
JONATHAN DAVID BLACKWELL
MT PLEASANT, SC
NPI
1124034483
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: SC 4780)
Enumeration Date
2006-07-31
Last Update Date
2007-07-08
Business Address
Mr. JONATHAN DAVID BLACKWELL PT Physical Therapis
607 A JOHNNIE DODDS BLVD
MT PLEASANT, SC 29464
Phone number: 843-884-7880
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Mailing Address
Mr. JONATHAN DAVID BLACKWELL PT Physical Therapis
PO BOX 1390
MT PLEASANT, SC 29465
Phone number: 843-884-7880
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