JOHN STEPHEN BLACKBURN

IRMO, SC
NPI1164490801
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TN  11770)
Enumeration Date2006-03-09
Last Update Date2007-07-08
Business Address
Mr. JOHN STEPHEN BLACKBURN CRNA
7210G BROAD RIVER RD
IRMO, SC 29063-7972
Phone number: 803-407-5266
Mailing Address
Mr. JOHN STEPHEN BLACKBURN CRNA
PO BOX 1637
IRMO, SC 29063-1637
Phone number: 803-407-5266
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