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General NPI Number Information
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NPI Number | 1851360747
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Entity Type | Individual
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Provider Name | HERBERT A BLASSENGALE CH
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 713 PENDLETON ST
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City | GREENVILLE
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State | SC
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Zip | 29601-3321
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Country | US
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Telephone | 864-232-5488
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Fax | 864-232-5388
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Provider Business Mailing Address
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Address Line | 713 PENDLETON STREET
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City | GREENVILLE
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State | SC
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Zip | 29601-3307
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Country | US
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Telephone | 864-232-5488
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Fax | 864-232-5388
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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 | 1782
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License Number State | SC
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