Most Relevant Information
Provider Data
| NPI Number: | 1003482308 |
| Provider Name: | TRISTAN TERRI BLANKENSHIP |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: | DCA |
Most Important Dates
| Enumeration Date: | 05/28/2021 |
| Last Updated: | 05/28/2021 |
Provider Practice Location
236 HOLLEY LN
PRICHARD
WV
255557680
Practice Location Phone/Fax
| Phone: | 3044883801 |
| Fax: |
Provider Mailing Location
236 HOLLEY LN
PRICHARD
WV
255557680
Provider Mailing Phone/Fax
| Phone: | 3044883801 |
| Fax: |