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1194106690
DEREK BLANKENSHIP
JACKSON, TN
NPI
1194106690
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TN 2793)
Enumeration Date
2015-06-10
Last Update Date
2015-10-05
Business Address
-- DEREK BLANKENSHIP PA-C
620 SKYLINE DR
JACKSON, TN 38301-3923
Phone number: 731-541-6180
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Mailing Address
-- DEREK BLANKENSHIP PA-C
620 SKYLINE DR
JACKSON, TN 38301-3923
Phone number:
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