JOHN LUTHER BLAYLOCK

PHOENIX, AZ
NPI1467129478
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date2021-08-26
Last Update Date2021-08-30
Business Address
JOHN LUTHER BLAYLOCK
2432 W PEORIA AVE
PHOENIX, AZ 85029-4726
Phone number: 480-431-5075
Mailing Address
JOHN LUTHER BLAYLOCK
2432 W PEORIA AVE
PHOENIX, AZ 85029-4726
Phone number: 480-431-5075
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