Individual provider · Type 1 NPI
Stan E. Blackburn, MS, PT
Specialist · Mansfield, TX
NPI number
1780893230
Active
Practice location
4003 Calloway Dr
Mansfield, TX 76063-3448
Fax (682) 518-5603
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 1027654 (TX) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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About NPI 1780893230
Stan E. Blackburn, MS, PT's National Provider Identifier is 1780893230, issued on May 22, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Mansfield, TX. The record was last updated on Jul 8, 2007.