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1831229186
GORDON J. BLACKNELL
LOS ANGELES, CA
NPI
1831229186
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2007-03-06
Last Update Date
2007-07-08
Business Address
Mr. GORDON J. BLACKNELL
12901 VENICE BLVD
LOS ANGELES, CA 90066-3509
Phone number: 310-390-3611
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Mailing Address
Mr. GORDON J. BLACKNELL
12901 VENICE BLVD
LOS ANGELES, CA 90066-3509
Phone number: 310-390-3611
Copy
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