Emily Blackbourn

NPI #1699179986 in Wayne, Michigan

Provider Information

NPI Number: 1699179986
Entity Type: Individual
Name: Emily Blackbourn
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician, Other
Enumeration Date: Oct 15, 2014
Last Updated: Oct 15, 2014

Practice Location

Address: 35640 W MICHIGAN AVE
City: Wayne
State: Michigan
ZIP Code: 48184-1628
Phone: (734) 729-7938

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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