NPI 1164112314

Stacey Blocker

Practitioner Private Vehicle Ellenwood, GA

Practice location

Address: 2343 River Rd, Ellenwood, GA 30294-1127
Phone: (904) 554-0248

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X

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Registry record

NPI: 1164112314
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 May 2023
Record last updated: 27 Nov 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.