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NPI Profile for GARY R BLACKBURN in NOBLESVILLE, IN.
An organization which supplies or vends orthopedic appliances or apparatuses and artificial body parts used to support, align, prevent, or correct deformities or to replace or improve function of body parts.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Prosthetic/Orthotic Supplier |
335E00000X | 51 | Medical Supply Company with Orthotist | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI # | 1467896258 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/23/2013 | |
| Last updated | 07/03/2013 - About 13 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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GARY R BLACKBURN