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1902460272
CRYSTAL JHAN BLAINE
LEXINGTON, KY
NPI
1902460272
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
(Licence: KY B98103599)
Enumeration Date
2019-04-23
Last Update Date
2019-04-23
Business Address
CRYSTAL JHAN BLAINE
1351 NEWTOWN PIKE BLDG 1
LEXINGTON, KY 40511-1277
Phone number: 859-253-1686
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Mailing Address
CRYSTAL JHAN BLAINE
1351 NEWTOWN PIKE BLDG 1
LEXINGTON, KY 40511-1277
Phone number:
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