KENNETH BLANTON

TYLER, TX
NPI1962986810
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: TX  70668)
Additional Taxonomies1835N0905X Pharmacist, Nuclear
(Licence: TX  70668)
Enumeration Date2018-09-17
Last Update Date2024-01-18
Business Address
KENNETH BLANTON
1301 CLINIC DR
TYLER, TX 75701-2120
Phone number: 903-592-8635
Mailing Address
KENNETH BLANTON
5935 PINE CONE LN
TYLER, TX 75707-6288
Phone number: 903-830-4148