MICHAELA ROSE BLACKWELL

ROCKFORD, IL
NPI1407553019
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085010688)
Enumeration Date2023-02-14
Last Update Date2024-11-01
Business Address
MICHAELA ROSE BLACKWELL PA-C
5875 E RIVERSIDE BLVD
ROCKFORD, IL 61114-4937
Phone number: 815-398-9491
Mailing Address
MICHAELA ROSE BLACKWELL PA-C
PO BOX 735263
CHICAGO, IL 60673-5263
Phone number:
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