Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice | |
Clinic Pharmacy |
3336C0002X | 58 | Medical Supply Company with Pharmacist | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice |
| NPI # | 1730906348 |
| LBN Legal business name | BLANE CLINICAL LLC |
| Authorized official | MARLIN BLANE - (AO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/24/2024 |
| Last updated | 10/14/2025 - About 8 months ago |
| Identifiers | n/a |
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BLANE CLINICAL LLC
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