Blalock, Mary
Blalock, Mary is an individual health care provider with primary practice located at 107 Lake Reserve Way , Holly Springs GA 30115-4785. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Blalock, Mary can be contacted via phone (770) 354-0471.Contact Information
Primary practice address
107 Lake Reserve Way
Holly Springs GA 30115-4785
Phone: (770) 354-0471
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN129711 | Georgia |
Profile Details
| NPI number | 1003349671 |
|---|---|
| LBN Legal business name | Blalock, Mary |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2017 |
| Last updated | Apr 10th, 2017 - about 7 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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