KENNY RAY BLACKSTON

OPP, AL
NPI1740286301
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy152W00000X Optometrist
(Licence: AL  S950-TA-529)
Enumeration Date2005-06-28
Last Update Date2008-01-17
Business Address
Dr. KENNY RAY BLACKSTON O.D.
102 W COVINGTON AVE
OPP, AL 36467-2033
Phone number: 334-774-9396
Mailing Address
Dr. KENNY RAY BLACKSTON O.D.
102 W COVINGTON AVE
OPP, AL 36467-2033
Phone number: 334-774-9396