Blackburn, Keith Jeremy

Blackburn, Keith Jeremy is an individual health care provider with primary practice located at 171 Graham St , Gardner MA 01440-3847. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Blackburn, Keith Jeremy can be contacted via phone (978) 632-4574.

Contact Information

Primary practice address
171 Graham St Gardner MA 01440-3847
Phone: (978) 632-4574
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1275114977
LBN Legal business name Blackburn, Keith Jeremy
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2021
Last updated Apr 15th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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