Sandra Lee Blackwell

NPI #1407607476 in Kentwood, Michigan

Provider Information

NPI Number: 1407607476
Entity Type: Individual
Name: Sandra Lee Blackwell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chore Provider
Enumeration Date: Mar 28, 2024
Last Updated: Mar 28, 2024

Practice Location

Address: 4728 WOLF RUN AVE SE
City: Kentwood
State: Michigan
ZIP Code: 49548-7570
Phone: (616) 734-3204

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chore Provider	372500000X	Primary

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