Brandon Robert Blalock

NPI #1093560104 in Overland Park, Kansas

Provider Information

NPI Number: 1093560104
Entity Type: Individual
Name: Brandon Robert Blalock
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician, Other
Enumeration Date: Apr 22, 2024
Last Updated: Jan 15, 2025

Practice Location

Address: 5799 BROADMOOR ST
City: Overland Park
State: Kansas
ZIP Code: 66202-2427
Phone: (660) 202-7899

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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