William Kelly Blackburn, MASSAGE THERAPY
NPI #1033683529 in Kent, Washington
Provider Information
- NPI Number
- 1033683529
- Entity Type
- Individual
- Name
- William Kelly Blackburn, MASSAGE THERAPY
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Massage Therapist
- Credential
- MASSAGE THERAPY
- Enumeration Date
- Jan 17, 2019
- Last Updated
- Jan 17, 2019
Practice Location
- Address
- 24620 RUSSELL RD APT D102
- City
- Kent
- State
- Washington
- ZIP Code
- 98032-4745
- Phone
- (941) 276-5651
Specialties & Taxonomy Codes
| Specialty |
|---|
| Massage Therapist |
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