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1881024776
EBONY BLACKMON
ATLANTA, GA
NPI
1881024776
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2013-11-14
Last Update Date
2013-11-14
Business Address
-- EBONY BLACKMON PA
80 JESSE HILL JR DR SE
ATLANTA, GA 30303-3031
Phone number: 404-616-6419
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Mailing Address
-- EBONY BLACKMON PA
3817 NORTHUMBERLAND DR
LOUISVILLE, KY 40245-1890
Phone number: 502-641-7689
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