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1275563694
JOHN C. BLACKENBURG
SELMA, AL
NPI
1275563694
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: AL S498-TA014)
Enumeration Date
2006-07-03
Last Update Date
2007-07-08
Business Address
Dr. JOHN C. BLACKENBURG O.D.
700 DALLAS AVE
SELMA, AL 36701-5451
Phone number: 850-622-0364
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Mailing Address
Dr. JOHN C. BLACKENBURG O.D.
2080 OLDE TOWNE AVE
MIRAMAR BEACH, FL 32550-6500
Phone number: 850-622-0364
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