John C Blackenburg Od LLC

NPI #1679896344 in Semmes, Alabama

Provider Information

NPI Number: 1679896344
Entity Type: Organization
Organization Name: John C Blackenburg Od LLC
Primary Specialty: Optometrist
Enumeration Date: Mar 9, 2010
Last Updated: Aug 3, 2010

Practice Location

Address: 7930 MOFFETT RD
City: Semmes
State: Alabama
ZIP Code: 36575-5490
Phone: (251) 645-2991

Authorized Official

Name: DR. JOHN C BLACKENBURG, OD
Title: OWNER
Phone: (251) 645-2991

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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