Robert Lee Blackwell III
Specialist/Technologist, Athletic Trainer in Lakeland, TN. Individual provider (NPI-1).
NPI number1942017181
StatusActive
Last updated in NPPESDec 11, 2024
Details
- NPI
- 1942017181
- Entity type
- Individual (NPI-1)
- Name
- Robert Lee Blackwell III
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 11, 2024
- Certification date
- Dec 11, 2024
- Last updated
- Dec 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
5292 Day Lily DrLakeland, TN 38002-5351
Phone 901-389-0205
Mailing address
5292 Day Lily DrLakeland, TN 38002-5351
Phone 901-389-0205
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