LISA ANN BLACKLIDGE

BRADENTON, FL
NPI1275596728
Former NameLISA ANN BUCHIANICO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: FL  PA9101122)
Enumeration Date2006-04-07
Last Update Date2022-07-21
Business Address
-- LISA ANN BLACKLIDGE PA-C
206 2ND ST E
BRADENTON, FL 34208-1042
Phone number: 941-746-5111
Mailing Address
-- LISA ANN BLACKLIDGE PA-C
367 S. GULPH RD ATT IPM CREDENTIALING
KING OF PRUSSIA, PA 19406-3121
Phone number: 775-356-9393
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