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General NPI Number Information
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NPI Number | 1457521007
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Entity Type | Individual
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Provider Name | ABIGAIL HOLLIS BLACKBURN DC
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Gender | Female
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 12/15/2016
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Provider Practice Location Address
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Address Line | 4107 MEDICAL PKWY STE 100
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City | AUSTIN
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State | TX
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Zip | 78756-3736
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Country | US
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Telephone | 512-420-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 4107 MEDICAL PKWY
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City | AUSTIN
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State | TX
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Zip | 78756-3735
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Country | US
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Telephone | 512-810-0667
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10841
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License Number State | TX
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