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1306344049
JASON BARRY BLACKBURN
SOUTHFIELD, MI
NPI
1306344049
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: MI 4704286557)
Enumeration Date
2018-01-29
Last Update Date
2018-01-29
Business Address
JASON BARRY BLACKBURN CRNA
16001 W 9 MILE RD
SOUTHFIELD, MI 48075-4818
Phone number: 248-849-2037
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Mailing Address
JASON BARRY BLACKBURN CRNA
21921 TROMBLY ST
SAINT CLAIR SHORES, MI 48080-1282
Phone number: 586-899-0774
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