MR. Stan E. Blackburn, MS, PT

NPI #1780893230 in Mansfield, Texas

Provider Information

NPI Number: 1780893230
Entity Type: Individual
Name: MR. Stan E. Blackburn, MS, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: MS, PT
Enumeration Date: May 22, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 4003 CALLOWAY DR
City: Mansfield
State: Texas
ZIP Code: 76063-3448
Phone: (817) 727-3182

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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