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1467129478
JOHN LUTHER BLAYLOCK
PHOENIX, AZ
NPI
1467129478
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date
2021-08-26
Last Update Date
2021-08-30
Business Address
JOHN LUTHER BLAYLOCK
2432 W PEORIA AVE
PHOENIX, AZ 85029-4726
Phone number: 480-431-5075
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Mailing Address
JOHN LUTHER BLAYLOCK
2432 W PEORIA AVE
PHOENIX, AZ 85029-4726
Phone number: 480-431-5075
Copy
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