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1467640375
THERON BLICKENSTAFF
KINGSPORT, TN
NPI
1467640375
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2083X0100X Preventive Medicine, Occupational Medicine
(Licence: TN 14559)
Enumeration Date
2007-10-05
Last Update Date
2007-10-05
Business Address
Dr. THERON BLICKENSTAFF M.D.
709 CLANDON DR
KINGSPORT, TN 37660-5036
Phone number: 423-378-3267
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Mailing Address
Dr. THERON BLICKENSTAFF M.D.
709 CLANDON DR
KINGSPORT, TN 37660-5036
Phone number: 423-378-3267
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