Kenny R Blackston Od PC

NPI #1710028618 in Andalusia, Alabama

Provider Information

NPI Number: 1710028618
Entity Type: Organization
Organization Name: Kenny R Blackston Od PC
Primary Specialty: Optometrist
Enumeration Date: Feb 12, 2007
Last Updated: Aug 26, 2024

Practice Location

Address: 1306 RIVER FALLS ST
City: Andalusia
State: Alabama
ZIP Code: 36421-2081
Phone: (334) 222-6325

Authorized Official

Name: MRS. STEPHANIE BLACKSTON
Title: OFFICE MANAGER
Phone: (334) 222-6325

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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